This Article Full Text Full Text (PDF) All Versions of this Article: 93/6/2079    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Google Scholar Articles by Ibáñez, L. Articles by de Zegher, F. PubMed PubMed Citation Articles by Ibáñez, L. Articles by de Zegher, F. Related Collections Pediatric Endocrinology Metabolism

Visceral Adiposity without Overweight in Children Born Small for Gestational Age

Endocrinology Unit (L.I., L.S., M.D.), Hospital Sant Joan de Déu, University of Barcelona, 08950 Esplugues, Barcelona, Spain; Diabetes, Endocrinology & Nutrition Unit (A.L.-B.), Dr. Trueta Hospital, 17007 Girona, Spain; Endocrinology Unit (M.V.M.), Hospital de Terrassa, 08227 Terrassa, Spain; and Department of Woman & Child (F.d.Z.), University of Leuven, 3000 Leuven, Belgium

Address all correspondence and requests for reprints to: Lourdes Ibáñez, M.D., Ph.D., Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950 Esplugues, Barcelona, Spain. E-mail: libanez{at}hsjdbcn.org.

Context: Children born small for gestational age (SGA) tend to develop catch-up growth in infancy and become overweight by the age of 6 yr. Weight control is advocated as a preventive measure, but it is unknown whether such control suffices to prevent visceral fat excess and hypoadiponectinemia.

Setting: The study was performed at a university hospital.

Study Population and Design: A total of 64 children (32 matched pairs) aged 6 yr, of whom 32 were born appropriate for gestational age and 32 were born SGA, and had subsequently developed spontaneous catch-up growth were included in the study; matching was performed for gender, height, weight, and, thus, body mass index.

Main Outcomes: Fasting insulin, IGF-I, high molecular weight adiponectin, leptin, visfatin, and lean and fat mass were calculated by absorptiometry, and abdominally sc and visceral fat by magnetic resonance imaging.

Results: After strict matching, SGA children had a total lean mass, total fat mass, leptinemia, and visfatinemia comparable to those in the appropriate for gestational age children, but they still had higher fasting insulin and IGF-I levels (P < 0.01), much lower high molecular weight adiponectin levels (P < 0.0001), and a striking shift from abdominally sc to visceral fat (P < 0.0001). Fasting insulin (r = 0.52; P < 0.00001) was a major determinant of visceral fat in boys and girls, explaining 28% of its variance.

Conclusions: SGA children tend to be viscerally adipose and hypo-adiponectinemic, even if they are not overweight. Therefore, measures beyond weight control seem to be needed to allow most SGA children to normalize their body composition and endocrine-metabolic homeostasis.

This article has been cited by other articles:

				R. L. Barbieri Update in Female Reproduction: A Life-Cycle Approach J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2439 - 2446. [Abstract] [Full Text] [PDF]

				L. Ibanez, G. Sebastiani, A. Lopez-Bermejo, M. Diaz, M. D. Gomez-Roig, and F. de Zegher Gender Specificity of Body Adiposity and Circulating Adiponectin, Visfatin, Insulin, and Insulin Growth Factor-I at Term Birth: Relation to Prenatal Growth J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2774 - 2778. [Abstract] [Full Text] [PDF]