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Abdominal Fat Partitioning and High-Molecular-Weight Adiponectin in Short Children Born Small for Gestational Age

Endocrinology Unit (L.I., M.D., P.C.), Hospital Sant Joan de Déu, University of Barcelona, 08950 Esplugues, Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (L.I., M.D., P.C.), ISCIII, 28029 Madrid, Spain; Department of Pediatrics (A.L.-B.), Dr. Josep Trueta Hospital, University of Girona, 17007 Girona, Spain; Endocrinology Unit (M.V.M.), Hospital de Terrassa, 08227 Terrassa, Spain; and Department of Woman and 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 and Objective: Children born small for gestational age (SGA) tend to become hyperinsulinemic and viscerally adipose and to have low levels of circulating high-molecular-weight (HMW) adiponectin upon completion of catch-up growth. We studied whether the same applies to SGA children, who failed to develop spontaneous catch-up growth.

Setting: The study was conducted at a university hospital.

Patients: Patients included 24 short SGA children (11 girls, 13 boys; mean age 7.5 yr, height –3.0 SD) as compared with appropriate-for-gestational-age (AGA) children (n = 32) and catch-up SGA children (n = 32) of similar height, weight, and body mass index.

Main Outcomes: We measured fasting serum glucose, insulin, IGF-I, and HMW adiponectin; body composition by absorptiometry; and abdominal fat partitioning by magnetic resonance imaging.

Results and Conclusion: Short SGA children were highly sensitive to insulin (P < 0.001 vs. AGA; P < 0.0001 vs. catch-up SGA), had low IGF-I levels, and had high-normal levels of HMW adiponectin (mean 14.0 vs. 7.4 mg/liter in catch-up SGA; P < 0.001). In the abdominal region, short SGA children had a normal amount of visceral fat (mean 17 vs. 18 cm² in AGA), but their sc fat was strikingly reduced (mean 18 vs. 29 cm² in AGA; P < 0.0001); this combination resulted in a markedly elevated ratio of visceral over sc fat (P < 0.0001 vs. AGA). The effects of GH therapy on these features of short SGA children remain to be studied.

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