ESPE Abstracts

Background: Birth weight (BW) is associated with the development of obesity, insulin resistance and type-2 diabetes in adulthood. The results of studies on the correlation between BW and the severity of obesity and cardiovascular risk factors (CVRF) among obese children are contradictory. The objective of our study was to evaluate the association between birth weight and the presence of CVRF in genetically homogeneous group of obese children and adolescents.

Subject and Methods: 789 obese children and adolescents of Sardinian descent (median age 9.54 years (2.6-17.7); 359 males), all born from uneventful pregnancies, were included in the study. Anthropometric markers (body mass index (BMI), height, waist circumference (WC)), pubertal stage, systolic and diastolic blood pressure (SP, DP), lipids profile (HDL and triglycerides), fasting plasma glucose (GLU), and insulin were assessed. The HOMA index was calculated as insulin resistance index. Patients were divided according to BW into 5 groups (GP0, BW<2500 g, n = 37; GP1, BW≥2500-<3000 g, n = 144; GP2, BW ≥3000-<3500 g, n = 320; GP3, BW≥3500-<4000g, n = 226; GP4, BW ≥4000 g, n = 62).

Results: The 5 groups were matched for age, BMI-SDS, and male/female and prepubertal/pubertal ratio. Median insulin and HOMA were higher in GP0 than in the other groups (P = 0.02 and P = 0.03, respectively). Median HDL was lower in GP1 than in GP2 and GP4 (P = 0.02), similar results were obtained when only subjects born full term (n = 706) were considered. The other CVRF were similar in the 5 groups. We separately analyzed 586 subjects belonging to G1, G2, and G3 born with BW appropriate for gestational age (AGA). CVRF were similar among the 3 groups (GP1 n = 70, GP2 n = 293, GP3 n = 201). Similarly, CVRF were similar among the 525 AGA full term subjects (GP1 n = 57, GP2 n = 277, GP3 n = 184).

Conclusions: In our cohort of obese children and adolescents, low BW was associated with higher values of serum insulin and HOMA in the entire cohort and in the full term subjects, regardless of age, gender and pubertal stage. In the cohort of AGA and full term AGA subjects, BW is not associated with the BMI and the CVRF analyzed. These findings have important clinical implications for the follow-up of obese children.