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Pai SR, Padmanabha R, Kamalakar S, Aravind JV, Puttaswamy D, Pn Rao S, Jois SK, Kamath A, Kuriyan R. Comparison of growth patterns in the first year of life between term small for gestational age and appropriate for gestational age South Indian infants. BMJ Paediatr Open 2024; 8:e002477. [PMID: 38719565 PMCID: PMC11086450 DOI: 10.1136/bmjpo-2023-002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Early life growth trajectories of Indian small for gestational age (SGA) infants are sparse. This study aimed to compare longitudinal growth in appropriate for gestational age (AGA) and SGA infants during their first year of life. METHODS Apparently healthy term infants (52 SGA, 154 AGA) were recruited at birth and followed up till 1 year. Parental, sociodemographic characteristics and feeding patterns were recorded. Anthropometric measurements were assessed at birth, 3, 6, 9 and 12 months of age; Z scores and growth velocity at 3-month intervals were computed. Longitudinal measurements were compared between the two groups, using the two-way Friedmans test. Median regression with mixed effects was used to adjust covariates; p value <0.05 was considered statistically significant. RESULT AGA infants had significantly higher median weight (kg) (2.87 (2.67, 3.04) vs 2.39 (2.25, 2.54)) at birth, (7.08 (6.50, 7.54) vs 6.49 (6.13, 6.78)) at 6 months, (8.64 (7.92, 9.14) vs 7.90 (7.36, 8.54)) at 12 months, median length (cm) ((48.10 (47.20, 49.30) vs 46.75 (45.43, 47.50)) at birth, (65.50 (64.23, 66.98) vs 63.33 (62.26, 65.28)) at 6 months, (73.30 (71.58, 74.66) vs 71.55 (70.00, 73.30)) at 12 months. SGA infants had comparable weight velocity at all intervals except 9-12 months (6.62 (6.45, 6.79) vs (6.70 (6.51, 6.85)), being significantly higher than AGA infants. Differences in skinfold thicknesses between groups were observed only at birth. Exclusivity of breast feeding was significantly higher at 3 months in AGA, compared to SGA infants (80.9% vs 57.8%). Length velocity was comparable at all ages between groups. Sexual dimorphism was observed in the growth velocities of both groups. CONCLUSION SGA infants grew in parallel to AGA infants, having significantly lower anthropometric measurements at all time points. However, growth velocities were similar; SGA infants had significantly higher weight velocity from 9 to 12 months. Longitudinal studies beyond 1 year of age, using body composition are needed to determine the quality of growth in Indian infants.
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Affiliation(s)
- Shruti R Pai
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Ramya Padmanabha
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Sanjana Kamalakar
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Jini V Aravind
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Deepa Puttaswamy
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Suman Pn Rao
- Department of Neonatology, St John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Srinivas K Jois
- Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
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2
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Burton JJN, Alonso LC. Overnutrition in the early postnatal period influences lifetime metabolic risk: Evidence for impact on pancreatic β-cell mass and function. J Diabetes Investig 2024; 15:263-274. [PMID: 38193815 PMCID: PMC10906026 DOI: 10.1111/jdi.14136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024] Open
Abstract
Overconsumption of energy-rich foods that disrupt caloric balance is a fundamental cause of overweight, obesity and diabetes. Dysglycemia and the resulting cardiovascular disease cause substantial morbidity and mortality worldwide, as well as high societal cost. The prevalence of obesity in childhood and adolescence is increasing, leading to younger diabetes diagnosis, and higher severity of microvascular and macrovascular complications. An important goal is to identify early life conditions that increase future metabolic risk, toward the goal of preventing diabetes and cardiovascular disease. An ample body of evidence implicates prenatal and postnatal childhood growth trajectories in the programming of adult metabolic disease. Human epidemiological data show that accelerated childhood growth increases risk of type 2 diabetes in adulthood. Type 2 diabetes results from the combination of insulin resistance and pancreatic β-cell failure, but specific mechanisms by which accelerated postnatal growth impact one or both of these processes remain uncertain. This review explores the metabolic impact of overnutrition during postnatal life in humans and in rodent models, with specific attention to the connection between accelerated childhood growth and future adiposity, insulin resistance, β-cell mass and β-cell dysfunction. With improved knowledge in this area, we might one day be able to modulate nutrition and growth in the critical postnatal window to maximize lifelong metabolic health.
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Affiliation(s)
- Joshua JN Burton
- Division of Endocrinology, Diabetes and Metabolism and the Joan and Sanford I. Weill Center for Metabolic Health, Weill Cornell MedicineNew York CityNew YorkUSA
| | - Laura C Alonso
- Division of Endocrinology, Diabetes and Metabolism and the Joan and Sanford I. Weill Center for Metabolic Health, Weill Cornell MedicineNew York CityNew YorkUSA
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3
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Vipin VA, Blesson CS, Yallampalli C. Maternal low protein diet and fetal programming of lean type 2 diabetes. World J Diabetes 2022; 13:185-202. [PMID: 35432755 PMCID: PMC8984567 DOI: 10.4239/wjd.v13.i3.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/30/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
Maternal nutrition is found to be the key factor that determines fetal health in utero and metabolic health during adulthood. Metabolic diseases have been primarily attributed to impaired maternal nutrition during pregnancy, and impaired nutrition has been an immense issue across the globe. In recent years, type 2 diabetes (T2D) has reached epidemic proportion and is a severe public health problem in many countries. Although plenty of research has already been conducted to tackle T2D which is associated with obesity, little is known regarding the etiology and pathophysiology of lean T2D, a variant of T2D. Recent studies have focused on the effects of epigenetic variation on the contribution of in utero origins of lean T2D, although other mechanisms might also contribute to the pathology. Observational studies in humans and experiments in animals strongly suggest an association between maternal low protein diet and lean T2D phenotype. In addition, clear sex-specific disease prevalence was observed in different studies. Consequently, more research is essential for the understanding of the etiology and pathophysiology of lean T2D, which might help to develop better disease prevention and treatment strategies. This review examines the role of protein insufficiency in the maternal diet as the central driver of the developmental programming of lean T2D.
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Affiliation(s)
- Vidyadharan Alukkal Vipin
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Chellakkan Selvanesan Blesson
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
- Family Fertility Center, Texas Children's Hospital, Houston, TX 77030, United States
| | - Chandra Yallampalli
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
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4
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Guazzarotti L, Mauri S, Santi D, Pogliani L, Zuccotti G. First year metabolic and hormonal behaviour define two different populations of SGA newborn for weight or height. J Endocr Soc 2022; 6:bvac028. [PMID: 35350393 PMCID: PMC8944306 DOI: 10.1210/jendso/bvac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Indexed: 11/19/2022] Open
Abstract
Abstract
Context
Small for gestational age (SGA) children have a particular metabolic and hormonal pattern at birth that change rapidly.
Objective
To evaluate the linear and weight growth in the first year of life in SGA children.
Design
Prospective, monocentric cohort study.
Setting
Real-world data collected from April 2012 to January 2016.
Patients
SGA newborns uniformly defined by either growth or length lower than -2 standard deviation for gestational age.
Interventions
All children were evaluated for one year after birth, at three days of life, then three, six and 12 months after birth.
Main outcome measures
Anthropometric parameters and biochemical variables, such as blood glucose, insulin, leptin, insulin-like growth factor (IGF)-1, IGF binding protein (IGFBP)3, and HOMA index.
Results
One hundred and thirty-three SGA children were enrolled. Length significantly improved one month after birth, whereas weight significantly increased only three months after birth. Biochemical variables increased during the first year of life, showing a prediction by IGFBP-3 and HOMA-index. Then, the casuistry was divided considering either weight, length or both, showing a different incidence. The biochemical variables changes recorded in the first step were maintained considering SGA children for weight or length, whereas they disappeared when weight and length were considered together.
Conclusions
Our study shows a specific catch-up growth for weight and length in SGA children. Moreover, we highlight that weight and length should be considered as independent parameters in SGA children, defining two different metabolic-hormonal populations with different conceivable predictive role in early catch-up growth and in later growth and metabolic status.
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Affiliation(s)
- Laura Guazzarotti
- Endocrinology Unit, Pediatric Department, University of Padua, Italy
| | - Silvia Mauri
- Pediatric Department, University of Milan “V Buzzi” Children’s Hospital ASST FBF Sacco, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | | | - Gianvincenzo Zuccotti
- Pediatric Department, University of Milan “V Buzzi” Children’s Hospital ASST FBF Sacco, Italy
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5
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Martín-Calvo N, Goni L, Tur JA, Martínez JA. Low birth weight and small for gestational age are associated with complications of childhood and adolescence obesity: Systematic review and meta-analysis. Obes Rev 2022; 23 Suppl 1:e13380. [PMID: 34786817 DOI: 10.1111/obr.13380] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022]
Abstract
In recent decades, the incidence of type 2 diabetes (T2D) has increased dramatically in children and adolescents, posing a real public health problem. Beyond unhealthy diets and sedentary lifestyles, growing evidence suggests that some perinatal factors, such as low birth weight (LBW), are associated with higher risk of T2D in adulthood. In this regard, it remains unclear whether the increased risk is already present in childhood and adolescence. We conducted a systematic review and meta-analysis to clarify the association of LBW or being small for gestational age (SGA) with insulin resistance in childhood and adolescence. The systematic review resulted in 28 individual studies, and those with the same outcome were included within two random-effects meta-analyses. Compared with children or adolescents born with adequate size for gestational age, those SGA had 2.33-fold higher risk of T2D (95% confidence interval [CI]: 1.05-5.17). Furthermore, LBW and being SGA were associated with 0.20 higher mean homeostasis model assessment of insulin resistance (HOMA-IR) values (95% CI: 0.02-0.38). Given the high prevalence of preterm babies, from a population perspective, these results may be of great importance as they point to the existence of a potentially vulnerable subgroup of children and adolescents that could benefit from screening tests and early preventive strategies.
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Affiliation(s)
- Nerea Martín-Calvo
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Leticia Goni
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Josep A Tur
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS & IDISBA, Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, Madrid, Spain.,Center for Nutrition Research, University of Navarra, Pamplona, Spain
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6
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Hong YH, Chung S. Small for gestational age and obesity related comorbidities. Ann Pediatr Endocrinol Metab 2018; 23:4-8. [PMID: 29609443 PMCID: PMC5894558 DOI: 10.6065/apem.2018.23.1.4] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/15/2018] [Indexed: 12/19/2022] Open
Abstract
Infant born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature and metabolic alterations in later life. The result of SGA followed by rapid weight gain during early postnatal life has been associated with increased long-term risks for central obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes, hypertension, increased fat mass, and cardiovascular disease. We should carefully monitor their weight during infancy and childhood to prevent excessive rates of weight gain. 'Healthy catch up growth' may decreased the risk of obesity-related comorbidities in SGA. Establishing the optimal growth patterns in SGA to minimize short- and long-term risks is important, and further studies will be needed. This review discusses recent studies concentrating on obesity-related morbidities in SGA infants that may provide insight into growth monitoring.
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Affiliation(s)
- Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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7
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Peng P, Ma CL, Wan SM, Jin WS, Gao Y, Huang TQ, Cheng Q, Ye CL. [Effect of metformin on insulin resistance during catch-up growth in mice with fetal growth restriction]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1126-1130. [PMID: 28801297 PMCID: PMC6765734 DOI: 10.3969/j.issn.1673-4254.2017.08.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To study the efficacy of metformin intervention on insulin resistance during catch-up growth in mice with fetal growth restriction (FGR). METHODS Mouse models of FGR were established by low protein diet feeding of the pregnant mice. Both the newborn female mice with FGR and normal control (NC) mice were randomized for feeding with a standard diet (SF) or a high-fat diet (HF) after weaning and treatment with gavage of either metformin or normal saline. The mice were examined for vaginal opening time and the estrous cycle at the age of 8 weeks. At the age of 12 weeks, 6 mice in anestrus from each group were fasted for 12 h for measurement of body weight, height, poundera index (PI), fasting blood glucose (FBG), fasting insulin (Fins), follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH), and the HOMA-IR was calculated. The reproductive capacity of female mice was assessed by mixing them with male mice at the ratio of 2:1. The 3 × 2 factorial analysis was conducted to determine the interactions between FGR, high-fat feeding and metformin. RESULTS Factorial analysis showed that FGR and high-fat feeding had significant effects on the PI index, Fins, HOMA-IR, vaginal opening time, and AMH (P<0.05). Metformin significantly affected the factors related to high-fat feeding including weight, PI, FPG, Fins, HOMA-IR and estrous cycle (P<0.05) and the factors related to FGR with the exception of height and FSH (P<0.05). FGR significantly affected the factors tested except for body weight (P<0.05); high-fat feeding affected all the factors but the FSH (P<0.05); metformin affected all the factors but the height and FSH (P<0.05). In the female mice treated with saline, the pregnancy rates differed significantly between FGR mice with high-fat feeding and control mice with standard feeding, and between FGR mice with standard feeding and high-fat feeding (P<0.05). CONCLUSION FGR mice can present with delayed puberty with rare ovulation and adulthood insulin resistance, and high-fat feeding after birth can promote the catch-up growth of FGR mice. Metformin intervention is effective for improving insulin resistance and reproductive-endocrine disorders in FGR mice during catch-up growth.
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Affiliation(s)
- Ping Peng
- Department of Obstetrics and Gynecology, Guangzhou General Hospital of Guangzhou Military Command of PLA, Guangzhou 510010, China. E-mail:
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8
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Castanys-Muñoz E, Kennedy K, Castañeda-Gutiérrez E, Forsyth S, Godfrey KM, Koletzko B, Ozanne SE, Rueda R, Schoemaker M, van der Beek EM, van Buuren S, Ong KK. Systematic review indicates postnatal growth in term infants born small-for-gestational-age being associated with later neurocognitive and metabolic outcomes. Acta Paediatr 2017; 106:1230-1238. [PMID: 28382722 PMCID: PMC5507303 DOI: 10.1111/apa.13868] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/01/2017] [Accepted: 04/03/2017] [Indexed: 12/22/2022]
Abstract
We systematically reviewed papers published in English between 1994 and October 2015 on how postnatal weight gain and growth affect neurodevelopment and metabolic outcomes in term‐born small‐for‐gestational‐age (SGA) infants. Two randomised trials reported that enriched infant formulas that promoted early growth also increased fat mass, lean mass and blood pressure (BP), but had no effect on early neurocognitive outcomes. Meanwhile, 31 observational studies reported consistent positive associations between postnatal weight gain and growth with neurocognitive outcomes, adiposity, insulin resistance and BP. Conclusion: Few intervention studies exist, despite consistent positive associations between early growth and neurocognition in term‐born SGA infants.
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Affiliation(s)
| | - Kathy Kennedy
- UCL Great Ormond Street Hospital Institute of Child Health; London UK
| | | | | | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität Munich; Dr. von Hauner Children's Hospital; University of Munich Medical Center; München Germany
| | - Susan E. Ozanne
- Metabolic Research Laboratories & MRC Metabolic Diseases Unit; Institute of Metabolic Science; University of Cambridge; Cambridge UK
| | | | | | - Eline M. van der Beek
- Nutricia Research; Danone Nutricia Early Life Nutrition; Utrecht The Netherlands
- Department of Pediatrics; University Medical Center Groningen; Groningen The Netherlands
| | - Stef van Buuren
- Netherlands Organisation for Applied Scientific Research TNO; Leiden The Netherlands
- University of Utrecht; Utrecht The Netherlands
| | - Ken K. Ong
- MRC Epidemiology Unit; University of Cambridge; Cambridge UK
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9
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Blesson CS, Chinnathambi V, Kumar S, Yallampalli C. Gestational Protein Restriction Impairs Glucose Disposal in the Gastrocnemius Muscles of Female Rats. Endocrinology 2017; 158:756-767. [PMID: 28324067 PMCID: PMC5460798 DOI: 10.1210/en.2016-1675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/23/2017] [Indexed: 01/18/2023]
Abstract
Gestational low-protein (LP) diet causes hyperglycemia and insulin resistance in adult offspring, but the mechanism is not clearly understood. In this study, we explored the role of insulin signaling in gastrocnemius muscles of gestational LP-exposed female offspring. Pregnant rats were fed a control (20% protein) or an isocaloric LP (6%) diet from gestational day 4 until delivery. Normal diet was given to mothers after delivery and to pups after weaning until necropsy. Offspring were euthanized at 4 months, and gastrocnemius muscles were treated with insulin ex vivo for 30 minutes. Messenger RNA and protein levels of molecules involved in insulin signaling were assessed at 4 months. LP females were smaller at birth but showed rapid catchup growth by 4 weeks. Glucose tolerance test in LP offspring at 3 months showed elevated serum glucose levels (P < 0.01; glycemia Δ area under the curve 342 ± 28 in LP vs 155 ± 23 in controls, mmol/L * 120 minutes) without any change in insulin levels. In gastrocnemius muscles, LP rats showed reduced tyrosine phosphorylation of insulin receptor substrate 1 upon insulin stimulation due to the overexpression of tyrosine phosphatase SHP-2, but serine phosphorylation was unaffected. Furthermore, insulin-induced phosphorylation of Akt, glycogen synthase kinase (GSK)-3α, and GSK-3β was diminished in LP rats, and they displayed an increased basal phosphorylation (inactive form) of glycogen synthase. Our study shows that gestational protein restriction causes peripheral insulin resistance by a series of phosphorylation defects in skeletal muscle in a mechanism involving insulin receptor substrate 1, SHP-2, Akt, GSK-3, and glycogen synthase causing dysfunctional GSK-3 signaling and increased stored glycogen, leading to distorted glucose homeostasis.
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Affiliation(s)
| | - Vijayakumar Chinnathambi
- Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas 77555
| | - Sathish Kumar
- Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas 77555
| | - Chandrasekhar Yallampalli
- Basic Sciences Perinatology Research Laboratories, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030
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10
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Liu C, Wu B, Lin N, Fang X. Insulin resistance and its association with catch-up growth in Chinese children born small for gestational age. Obesity (Silver Spring) 2017; 25:172-177. [PMID: 27865057 DOI: 10.1002/oby.21683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/08/2016] [Accepted: 08/25/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess insulin resistance and β-cell function from birth to age 4 years and to examine their associations with catch-up growth (CUG) in Chinese small-for-gestational-age (SGA) children. METHODS Weight and height were measured yearly from birth to age 4 years, and transformed into age- and gender-adjusted SD scores. Fasting serum insulin and glucose were measured, and fasting insulin resistance and β-cell function were estimated using the homeostasis model assessment (HOMA). RESULTS The mean HOMA-IR of the SGA group was significantly lower than that of the appropriate-for-gestational-age (AGA) group at ages 2 and 3 years old, and the mean HOMA% of the SGA group was significantly lower than that of the AGA group at age 4 years old. At 4 years of age, HOMA for insulin resistance was positively correlated with the height gain and SD of height gain between 0 and 5 months, and HOMA% was positively correlated with the weight gain and SD of weight gain between 6 and 12 months in SGA children. CONCLUSIONS SGA children with CUG show a greater propensity to develop insulin resistance than AGA children between ages 2 and 4 years old. HOMA parameters are related to CUG in the first year of life.
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Affiliation(s)
- Chunhua Liu
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
| | - Baiyan Wu
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
| | - Niyang Lin
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
| | - Xiaoyi Fang
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
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11
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Cho WK, Suh BK. Catch-up growth and catch-up fat in children born small for gestational age. KOREAN JOURNAL OF PEDIATRICS 2016; 59:1-7. [PMID: 26893597 PMCID: PMC4753194 DOI: 10.3345/kjp.2016.59.1.1] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/15/2015] [Accepted: 08/20/2015] [Indexed: 12/17/2022]
Abstract
Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.
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Affiliation(s)
- Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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12
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Okada T, Takahashi S, Nagano N, Yoshikawa K, Usukura Y, Hosono S. Early postnatal alteration of body composition in preterm and small-for-gestational-age infants: implications of catch-up fat. Pediatr Res 2015; 77:136-42. [PMID: 25310764 DOI: 10.1038/pr.2014.164] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 09/09/2014] [Indexed: 12/12/2022]
Abstract
The concept of the developmental origins of health and disease is based on studies by Barker et al. They proposed a hypothesis that undernutrition in utero permanently changes the body's structure, function, and metabolism in ways that lead to atherosclerosis and insulin resistance in later life. In addition, profound effects on the extent of body fatness and insulin sensitivity are demonstrated, if there is a "mismatch" between prenatal and postnatal environments. In previous studies, undernutrition in utero has been evaluated simply by birth weight itself or birth weight for gestational age, and the degree of mismatch has been estimated by postnatal rapid weight gain. Recently, we investigated subcutaneous fat accumulation in small-for-gestational-age infants and found that a rapid catch-up in skinfold thickness developed prior to the body weight catch-up. Furthermore, insulin-like growth factor-I and lipoprotein lipase mass concentrations also demonstrate rapid increase during the neonatal period with fat accumulation. Investigating the precise mechanisms of developmental origins of health and disease including mediating metabolic and hormonal factors may provide a new approach to prevent atherosclerosis and insulin resistance. Better management of undernutrition during gestation and neonatal growth during the early postnatal period is an important theme for future health.
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Affiliation(s)
- Tomoo Okada
- 1] Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan [2] Department of Nutrition and Life Science, Kanagawa Institute of Technology, Kanagawa, Japan
| | - Shigeru Takahashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Kayo Yoshikawa
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Yukihiro Usukura
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Shigeharu Hosono
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
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13
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Saggese G, Fanos M, Simi F. SGA children: auxological and metabolic outcomes - the role of GH treatment. J Matern Fetal Neonatal Med 2014; 26 Suppl 2:64-7. [PMID: 24059556 DOI: 10.3109/14767058.2013.832870] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The definition Small for Gestational Age (SGA) describes those newborns weighing and/or measuring in length <-2 SD than expected for their gestational age. These subjects are at higher risk of short stature, neonatal complications, alterations of glucose, lipid metabolism, body composition, bone metabolism and puberty, neurocognitive vulnerabilities and alterations of the GH-IGF-I axis. With regards to growth, in 85-90% of the cases children born SGA experience a period of catch up growth that allows them to achieve an adult stature within normal range. In a 10-15% of the cases, the catch up growth period does not take place and this entails short stature in adulthood. In the latter group, GH treatment may be considered to achieve adult height in the range of genetical target stature. With reference to glucose and lipid metabolism, young adults born SGA and particularly those with early catch up growth are at higher risk of developing insulin resistance, type 2 diabetes mellitus, arterial hypertension, dyslipidemia, overweight, obesity and metabolic syndrome. Subjects born SGA are in need of a correct diagnostic and eventually therapeutic approach.
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Affiliation(s)
- Giuseppe Saggese
- Department of Pediatrics, Pediatric Endocrine Unit, University Hospital of Pisa , Italy
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14
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Deng HZ, Deng H, Cen CQ, Chen KY, Du ML. Post-receptor crosstalk between growth hormone and insulin signal in rats born small for gestational age with catch-up growth. PLoS One 2014; 9:e100459. [PMID: 24963636 PMCID: PMC4070916 DOI: 10.1371/journal.pone.0100459] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 05/25/2014] [Indexed: 11/18/2022] Open
Abstract
Objective Insulin resistance has been observed in individuals born small for gestational age (SGA) with catch-up growth (CUG), yet the mechanisms involved remain unclear. This study examined the role of GH and insulin signaling crosstalk in insulin resistance of SGA rats with CUG. Design and Methods SGA rats were developed by dietary restriction in pregnant rats. GH receptor inhibition was performed on four-week old CUG-SGA and AGA rats. Phosphorylation of IRS-1, AKT, and ERK, and expression of SOCS3 in the skeletal muscle were determined via immunoblot analysis at baseline and after insulin stimulation in CUG-SGA, NCUG-SGA and AGA groups. Results Compared to AGA controls, phosphorylation of IRS-1 and AKT in response to insulin stimulation in CUG-SGA rats was significantly blunted (P<0.05), and phosphorylation of ERK at baseline was dramatically activated (P<0.05). SOCS3 expression was significantly increased in CUG-SGA compared to AGA (P = 0.001) and NCUG-SGA (P = 0.006) rats, and was significantly suppressed following GHR inhibition (P<0.05). Furthermore, phosphorylation of IRS-1 and AKT in response to insulin stimulation increased after GHR inhibition (P<0.05). Conclusions Insulin resistance in CUG-SGA rats is associated with impairment of IRS-1-PI3K-AKT signaling, which may result from GH signaling-induced up-regulation of SOCS3.
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Affiliation(s)
- Hong-Zhu Deng
- Department of Pediatrics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Pediatrics, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hong Deng
- Department of Infectious diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail:
| | - Chao-Qun Cen
- Department of Pediatrics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kai-Yun Chen
- Department of Pediatrics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Min-Lian Du
- Department of Pediatrics, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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15
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Manios Y, Moschonis G, Papandreou C, Siatitsa PE, Iatridi V, Lidoriki I, Lionis C, Chrousos GP. Female sex, small size at birth and low family income increase the likelihood of insulin resistance in late childhood: the Healthy Growth Study. Pediatr Diabetes 2014; 15:41-50. [PMID: 23848453 DOI: 10.1111/pedi.12052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 04/14/2013] [Accepted: 05/03/2013] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify among a wide range of perinatal indices, as well as certain family sociodemographic and parental characteristics, those independently associated with insulin resistance (IR) in late childhood. METHODS A representative sample of 2195 Greek schoolchildren, aged 9-13 yr, was examined, and based on the biochemical indices collected IR was estimated using the homeostasis model assessment (HOMA-IR < 3.16). Perinatal data were recorded from children's medical records, retrospectively, while family sociodemographics and parental anthropometrics were reported by parents. RESULTS The overall prevalence of IR was 28.4%, with a higher prevalence observed for girls compared with boys (p <0.05). Examination of univariate associations, per se, showed that maternal current and pre-pregnancy overweight/obesity, maternal smoking at early pregnancy, children's small birth weight, and rapid growth at infancy as well as female sex and non-Caucasian race increased the likelihood of IR. In contrast, folate supplementation during pregnancy, as well as higher paternal education and annual family income decreased the likelihood of IR in children. Inclusion of all above variables at a multivariable regression model highlighted female sex [odds ratios (OR): 1.67, 95% confidence intervals (CI): 1.30-2.13], small birth weight (OR: 1.41, 95% CI: 1.03-2.01), and higher annual family income (OR: 0.71, 95% CI: 0.53-0.95 for 12 000-30 000 € and OR: 0.68, 95% CI: 0.48-0.96 for >30 000 €) as the only significant correlates of IR after also controlling for children's body mass index (BMI) and Tanner stage. CONCLUSIONS The current study highlighted small birth weight and female sex as the only perinatal factors independently associated with the occurrence of IR in late childhood, when examined at a multivariable level with a wide range of perinatal indices as well as certain family sociodemographic and parental characteristics.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition & Dietetics, Harokopio University of Athens, Athens, Greece
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16
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Does low birth weight affect the presence of cardiometabolic risk factors in overweight and obese children? Eur J Pediatr 2013; 172:1687-92. [PMID: 23913313 DOI: 10.1007/s00431-013-2113-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 07/17/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Recent findings suggest that low-birth-weight children with current obesity are more likely to have higher systolic blood pressure levels and impaired β-cell function than those who are obese with normal birth weight. It seems possible, however, that concurrent low birth weight with excess weight gain can exacerbate other risk factors for cardiometabolic diseases. The purpose of this study is to investigate the influence of birth weight on the lipid/apolipoprotein profile, visfatin levels, and insulin parameters in overweight/obese children. A cross-sectional study of 68 overweight/obese children was conducted. Among these children, 28 were identified with low birth weight and 40 were of normal birth weight. Blood lipid profile, apolipoproteins, visfatin, glucose, and insulin were measured. Our results show that systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, triglycerides (TG), very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDLc), apolipoprotein B and E, insulin, apolipoprotein B/A1 ratio, and homeostasis model assessment insulin resistance (HOMA-IR) were significantly elevated in overweight/obese low-birth-weight (LBW) children. There was a significant association of the SBP levels with TG (P=0.027), LDLc (P=0.001), HOMA-IR (P<0.001), apolipoprotein B (P=0.001), and apolipoprotein E (P=0.039). CONCLUSION Our findings suggest that LBW children with overweight or obesity have an additional risk factor for both atherogenic and insulinogenic profile.
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17
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Kuwahara E, Asakura K, Nishiwaki Y, Komatsu H, Nakazawa A, Ushiku H, Maejima F, Nishigaki Y, Hasegawa T, Okamura T, Takebayashi T. Steeper increases in body mass index during childhood correlate with blood pressure elevation in adolescence: a long-term follow-up study in a Japanese community. Hypertens Res 2013; 37:179-84. [DOI: 10.1038/hr.2013.109] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/01/2013] [Accepted: 07/31/2013] [Indexed: 11/09/2022]
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18
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Deng HZ, Deng H, Su Z, Li YH, Ma HM, Chen HS, Du ML. Insulin resistance and adiponectin levels are associated with height catch-up growth in pre-pubertal Chinese individuals born small for gestational age. Nutr Metab (Lond) 2012. [PMID: 23186039 PMCID: PMC3574033 DOI: 10.1186/1743-7075-9-107] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstracts
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Affiliation(s)
- Hong-Zhu Deng
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hong Deng
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhe Su
- Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yan-Hong Li
- Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hua-Mei Ma
- Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hong-Shan Chen
- Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Min-Lian Du
- Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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19
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Kent AL. Developmental origins of health and adult disease: what should neonatologists/paediatricians be considering about the long-term health of their patients? J Paediatr Child Health 2012; 48:730-4. [PMID: 22970665 DOI: 10.1111/j.1440-1754.2012.02541.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The developmental origins of health and disease hypothesis is now strongly supported by both animal and human evidence, and as a consequence, obstetricians, neonatologists and paediatricians need to consider the impact that the in utero and early post-natal environment can have on later renal, cardiovascular and metabolic health. Four common clinical scenarios were provided along with animal and human evidence identifying long-term health implications. Suggestions as to how we should translate this growing body of evidence into practice are provided.
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Affiliation(s)
- Alison L Kent
- Department of Neonatology, Canberra Hospital, Woden, Australian Capital Territory, Australia.
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Chiavaroli V, D'Adamo E, Giannini C, de Giorgis T, De Marco S, Chiarelli F, Mohn A. Serum levels of receptors for advanced glycation end products in normal-weight and obese children born small and large for gestational age. Diabetes Care 2012; 35:1361-3. [PMID: 22511256 PMCID: PMC3357256 DOI: 10.2337/dc11-2302] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess potential alterations in soluble and endogenous secretory receptors for advanced glycation end products (sRAGE and esRAGE) in normal-weight (NW) and obese (Ob) children born small (SGA) and large (LGA) compared with appropriate for gestational age (AGA) subjects and to explore if birth weight (BW), insulin resistance (IR), and obesity represent independent risk factors. RESEARCH DESIGN AND METHODS We categorized 130 prepubertal children into six groups according to BW and obesity and evaluated sRAGE, esRAGE, and homeostasis model assessment of IR. RESULTS sRAGE and esRAGE were lower in Ob SGA and LGA children than Ob AGA subjects (all P < 0.05), and in NW SGA and LGA children than NW AGA subjects (all P < 0.05). Interestingly, BW and IR were significantly and independently related to RAGE. CONCLUSIONS sRAGE and esRAGE are decreased in SGA and LGA children, and BW and IR seem to play an important role in the reduction of RAGE.
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Meazza C, Vitale G, Pagani S, Castaldi D, Ogliari G, Mari D, Laarej K, Tinelli C, Bozzola M. Common adipokine features of neonates and centenarians. J Pediatr Endocrinol Metab 2011; 24:953-7. [PMID: 22308847 DOI: 10.1515/jpem.2011.373] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adipose tissue seems to be a pivotal organ in the aging process. We investigated whether healthy aging could have its roots in a sound metabolic condition from the first year of life by evaluating leptin and adiponectin levels in neonates [33 adequate for gestational age (AGA) and 29 small for gestational age (SGA)], 48 centenarians, and 50 healthy elderly subjects. At birth, SGA neonates showed lower leptin levels (SGA 0.88 +/- 0.28; AGA 2.22 +/- 0.91 ng/mL; p < 0.05) and comparable adiponectin levels with respect to AGA. At 1 year, SGA showed increased leptin (SGA 1.74 +/- 0.28; AGA 1.31 +/- 0.19 ng/mL) and slightly reduced adiponectin concentrations (SGA 35.51 +/- 2.53; AGA 38.56 +/- 3.18 microg/mL) than AGA. Centenarians showed lower leptin (centenarians 18.71 +/- 3.78; elderly 34.81 +/- 7.27 ng/mL; p < 0.05) and higher adiponectin levels (centenarians 55.63 +/- 7.7; elderly 33.51 +/- 4.1 microg/mL; p < 0.05) than elderly subjects. Centenarians, like AGA infants during the first year of life, show a favorable adipokine profile, suggesting that the metabolic condition at early age could affect the longevity of an individual.
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Affiliation(s)
- Cristina Meazza
- Dipartimento di Scienze Pediatriche e Patologia Umana ed Ereditaria, Università di Pavia, Fondazione IRCCS San Matteo, Pavia, Italy
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