ESPE Abstracts

Background: Children born small-for-gestational-age (SGA) especially when they experience rapid catch-up growth have an increased risk for obesity and metabolic disturbances later in life.

Aims and objectives: Little is known about the effect of catch-down (c-d) growth and its effect on metabolic parameters in children born large-for-gestational-age (LGA).

Patients and methods: 101 pre-pubertal children with a birth-weight and/or length >95. P were examined at a median age of 8.0 years (range, 4.3 12.1). C-d was defined as postnatal change of SDS >0.67 during the first year of life. Fasting insulin, HbA1c, HOMA, lipoproteins, IGF-BP1, Leptin, Visfatin, Amylin, Ghrelin, IGF1, IGF-BP-3 were analysed.

Results: C-d for weight, length, and BMI was observed for the vast majority of the group (88%) during the first year beginning mostly at three months of age and lasting until one year and remained unchanged thereafter. However, actual mean height-SDS was still significant different from target height (0.67 SDS vs 0.22 SDS; P<0.001). Individuals who did not c-d were significantly taller (+1.57 SDS±0.85 vs 0.54 SDS±1.0; P=0.001) and heavier than those who c-d (weight-SDS (+0.99±0.59 vs 0.45±1.0; P=0.013). However, there was no significant difference for BMI-SDS (+0.34±0.67 vs 0.24±0.96; P=0.069) or other anthropometric parameters such as waist-, hip-, skinfold-thickness-SDS. No significant differences between the two groups were found for all measured metabolic and hormonal parameters.

Conclusion: The vast majority of infants born with LGA show a pronounced c-d growth, which lead to a rapid normalisation of length/height and weight. However, height-SDS remained significant different from target height. Although height and weight-SDS remained different between those LGA with vs. no c-d growth during the first year of life we could not find significant differences in parameters of body composition or the measured endocrine and metabolic parameters. Therefore, no signs of disturbance of carbohydrate or lipid metabolism was found in association to c-d growth.