Abdominal Fat Partitioning and High-Molecular-Weight Adiponectin in Short Children Born Small for Gestational Age

Context and Objective: Children born small for gestational age (SGA) tend to become hyperinsulinemic and viscerally adipose and to have low levels of circulating high-molecular-weight (HMW) adiponectin upon completion of catch-up growth. We studied whether the same applies to SGA children, who failed to develop spontaneous catch- up growth. Setting: The study was conducted at a university hospital. Patients: Patients included 24 short SGA children (11 girls, 13 boys; mean age 7.5 yr, height -3.0 SD) as compared with appropriate-for-gestational-age (AGA) children (n = 32) and catch-up SGA children (n = 32) of similar height, weight, and body mass index. Main Outcomes: We measured fasting serum glucose, insulin, IGF-I, and HMW adiponectin; body composition by absorptiometry; and abdominal fat partitioning by magnetic resonance imaging. Results and Conclusion: Short SGA children were highly sensitive to insulin (P < 0.001 vs. AGA; P < 0.0001 vs. catch-up SGA), had low IGF-I levels, and had high-normal levels of HMW adiponectin (mean 14.0 vs. 7.4 mg/liter in catch-up SGA; P < 0.001). In the abdominal region, short SGA children had a normal amount of visceral fat (mean 17 vs. 18 cm(2) in AGA), but their sc fat was strikingly reduced (mean 18 vs. 29 cm(2) in AGA; P < 0.0001); this combination resulted in a markedly elevated ratio of visceral over sc fat (P < 0.0001 vs. AGA). The effects of GH therapy on these features of short SGA children remain to be studied. (J Clin Endocrinol Metab 94: 1049-1052, 2009)