Context: Childhood obesity is supposed to affect growth and development in children but there is uncertainty with regard to dynamics and potential causes. We analyzed differences in age-related growth patterns of obese and normal-weight children and their association with circulating endocrine and metabolic factors.
Objective/Design: In a large German childhood cohort from Leipzig including 7986 children (22793 data sets) we compared cross-sectional and longitudinal data between normal-weight and obese individuals from birth to adulthood in a one-year resolution.
Results: Obese children were up to 1.5 SDS taller than normal-weight children in early childhood corresponding to a difference of almost 8 cm in total height. Analyses corrected for parental target height SDS revealed similar patterns, hence excluding familial predisposition as the major cause. Obese children started off with a significantly higher birth length (Difference: boys 0.33 cm, 0.11 SDS; girls: 0.52 cm, 0.23 SDS; all P<0.05) and weight-for-length of around 0.15 SDS and had an increased growth velocity of up to 1.5 cm/y in the first years of life. Subsequently, obese children showed a catch-down of height SDS starting at the age of 6 years. Particularly the pubertal growth spurt was blunted compared to normal-weight peers finally equalizing height SDS between normal-weight and obese children. When corrected for parental target height the height SDS of obese children remained slightly increased in adolescence, as the parents of obese children were around 1.2 cm smaller than those of normal-weight children. Girls with obesity entered puberty around 6 months earlier than normal-weight girls. The reduced growth velocity of obese children during puberty coincided with reduced levels of IGF-1 and with a reduction of around 50% in levels of testosterone in boys and estradiol in girls. There was no difference in IGFBP-3 levels between obese and normal-weight children. Leptin and fasting insulin levels were increased in obese children throughout late childhood and adolescence.
Conclusions: Patterns of linear growth and corresponding circulating hormone levels in obese children are distinct to those from normal-weight peers with a relative taller stature in early childhood followed by a catch-down growth.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology