ESPE Abstracts (2019) 92 FC4.3

Circulating Growth-and-Differentiation Factor-15 in Early Life: Relation to Prenatal and Postnatal Size

Marta Díaz1,2, Laura Campderrós3,4, Abel López-Bermejo5,6, Francis de Zegher7,8, Francesc Villarroya3,4, Lourdes Ibáñez1,2


1Endocrinology Unit, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain. 2Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Health Institute Carlos III, Madrid, Spain. 3Biochemistry and Molecular Biomedicine Department, Biomedicine Institute, University of Barcelona, Barcelona, Spain. 4Network Biomedical Research Center of Physiopathology of Obesity and Nutrition (CIBEROBN), Health Institute Carlos III, Madrid, Spain. 5Department of Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain. 6Girona Institute for Biomedical Research, Girona, Spain. 7Pediatric & Adolescent Endocrinology, University Hospital Gasthuisberg, Leuven, Belgium. 8Department of Development & Regeneration, University of Leuven, Leuven, Belgium


Background: Growth-and-differentiation factor-15 (GDF15) is a regulator of energy homeostasis, and is used as biomarker of several pathological states.

Objectives: To assess longitudinally GDF15 concentrations in a cohort of infants born either appropriate- (AGA, n=70) or small-for-gestational-age (SGA, n=33), the latter known to be at increased risk for central adiposity and metabolic alterations, particularly when they experience a rapid postnatal catch-up in weight.

Methods: Assessments included body length, weight, and ponderal index (PI); fasting glucose, insulin, IGF-I, HMW-adiponectin, GDF15; body composition (by absorptiometry) at birth, 4, 12 and 24 months.

Results: GDF15 levels at birth were significantly higher than those at each subsequent time point (P<0.001), and were similar in AGA and SGA subjects. GDF15 levels dropped at age 4 months, particularly in SGA infants (P=0.008 vs AGA), and continued to decline progressively in both subgroups reaching adult concentrations by age 24 months. GDF15 levels correlated inversely with the changes in PI and IGF-I at each time point, and with the gain in body fat over 24 months.

Conclusions: Early life is associated with supra-adult concentrations of GDF15. The reduced levels of GDF15 in SGA subjects early in postnatal life may be an adaptive mechanism to promote food intake and postnatal catch-up in weight, favoring a positive energy balance. Further follow-up will disclose whether this outcome may increase the risks for obesity later in life.

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