ESPE Abstracts (2023) 97 P1-517

ESPE2023 Poster Category 1 Growth and Syndromes (75 abstracts)

Bridging the gap between short stature and metabolic alterations in children born small for gestational age: an exploratory study

Giulia Rodari 1 , Valeria Citterio 2 , Valentina Collini 2 , Alessandro Risio 2 , Eriselda Profka 1 , Federico Giacchetti 1 , Maura Arosio 2,1 , Giovanna Mantovani 2,1 & Claudia Giavoli 2,1

1Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 2Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

Introduction: Children born small for gestational age (SGA) represent a heterogeneous population, displaying different phenotypes for both growth and metabolic status. Low birth length and/or weight increases the risks for not only growth impairment but also for metabolic derangements (cardiovascular disease, hypertension and type 2 diabetes), the latter with an even amplified risk in children with rapid postnatal weight gain. Variability in metabolic parameters, catch-up growth and different GH treatment responses are still poorly understood.

Aims: We investigated a possible association between anthropometric/metabolic parameters in SGA children.

Methods: This cross-sectional observational study evaluated a series of 32 children aged between 4 to15.7 years, with birth weight and/or length<-2.0SDS according to INeS Growth Charts. All patients with chronic conditions, GH deficiency, other endocrinopathies and genetic syndromes were excluded. Anthropometric (height-HT, Mid-parental height-MPH, weight, Body Mass Index-BMI, Tanner stage, body composition by Body Structure Analyzer BC-420MA TANITA) and metabolic (fasting glycemia and insulin, glycosylated haemoglobin-HbA1c) parameters were collected. Insulin resistance (HOMA-IR) and sensitivity (QUICKI) were calculated.

Results: Thirty-two SGA patients (F16/32,50%), with a mean age of 9.1±3.0 years were consecutively enrolled. In 18.7% of patients HT was below -2.0SDS. Mean HT was 126.5±15.2 cm, -1.09±1.13SDS according to WHO Growth Charts with a MPH distance (MPH SDS-HT SDS) of 0.62±1.10SDS. As far as glycemic profile was concerned, glycemia was in the normal range in all study patients apart from one with impaired fasting glucose (glycemia 107 mg/dL), mean glycemia was 83.3±8.5 mg/dL, mean HbA1c 34±3.1 mmol/mol, with a median HOMA-IR of 1.6 (IQR 0.9-3.1) and QUICKI of 0.35 (IQR 0.32-0.39). At multiple regression, HbA1c was positively associated with HT SDS (P=0.001) and negatively with MPH distance (P=0.017).

Conclusions: Our results suggest a relationship between postnatal catch-up growth and metabolic impairment, as underlined by the association found between HT and HbA1c, even after correction for MPH. This is only an explorative analysis; we would like to confirm our results on a larger scale. Moreover, considering that Fibroblast Growth Factor-21 (FGF-21), acting with its cofactor β-klotho, has recently emerged as a “starvation hormone” with a key role in the glucose metabolism regulation but also, interacting with GH/IGF-I axis, in longitudinal growth and growth hormone resistance, we ought to investigate FGF-21/β-Klotho system in our cohort in order to eventually bridge the gap between height gain and metabolic impairment in children born SGA.

Volume 97

61st Annual ESPE (ESPE 2023)

The Hague, Netherlands
21 Sep 2023 - 23 Sep 2023

European Society for Paediatric Endocrinology 

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