Catch-up growth in body mass index is associated neither with reduced insulin sensitivity nor with altered lipid profile in children born small for gestational age

Objective: Low birth weight is a risk factor for coronary heart disease. Persons who have coronary events as adults tend to have been small at birth and thin at 2 yr of age, after which they tended to increase their body mass index (BMI). Our aim was to determine whether BMI gain is associated to alterations in insulin sensitivity and/or lipid profile in children born small for gestational age (SGA). Design: Retrospective case-control study. Methods: We studied 78 children (mean age 7.8 +/- 2.5 yr): 26 SGA children with catch-up growth in BMI (CGB-SGA) (BMI = 10(th) to 75(th) centile), 26 SGA without catch-up growth (NCGB-SGA) (BMI<10(th) centile), and 26 appropriate for gestational age (AGA) control children (BMI: 10(th) to 75th centile). For each CGB-SGA child, we selected an NCGB-SGA and an AGA child of the same gender, age (within 1 yr), and pubertal status. SGA children were also subdivided into 2 groups according to post-natal catch-up growth in height (CGH). Results: Glucose was significantly lower in NCGB-SGA than AGA group (p=0.02). No significant differences in fasting insulin, fasting glucose/insulin ratio, homeostasis model assessment, quantitative insulin-sensitivity check index, and lipid profile were found among the 3 groups. HDL-cholesterol proved significantly reduced in SGA children with post-natal CGH (p=0.02). Conclusions: Our findings do not support the hypothesis of early alterations in insulin sensitivity and lipid metabolism in CGB-SGA subjects during childhood provided that BMI remains within the normal range. Finally, the finding of reduced HDL-cholesterol levels in CGH-SGA children suggests detrimental metabolic effects of the height gain.