Individuals born small-for-gestational age (SGA), especially those who experience postnatal catch-up growth, are at increased risk for developing endocrine-metabolic abnormalities before puberty In adults, brown adipose tissue (BAT) has been associated with protection against metabolic disorders, such as obesity, type 2 diabetes, and dyslipidaemia Here, we assessed for the first time whether BAT activation differs between prepubertal children born SGA or appropriate-for-gestational age (AGA) The study population consisted of 86 prepubertal children [41 AGA and 45 SGA; age (mean ± SEM), 85 ± 01 years], recruited into two prospective longitudinal studies assessing endocrine-metabolic status and body composition in infancy and childhood The temperature at the supraclavicular region (SCR) before and after a cold stimulus was measured by infrared thermal imaging, and the area of thermally active SCR (increase after cold challenge, ΔAreaSCR) was calculated as a surrogate index of BAT activation The results were correlated with clinical, endocrine-metabolic, and inflammation variables, and with visceral and hepatic adiposity (assessed by Magnetic Resonance Imaging) No differences in BAT activation index, as judged by ΔAreaSCR, were found between AGA and SGA children However, girls showed higher baseline and post-cold induction AreaSCR than boys (both p ≤ 001) An interaction between gender and birth weight subgroup was observed for BAT activation; AGA girls increased significantly the ΔAreaSCR as compared to AGA boys; this increase did not occur in SGA girls vs SGA boys Cold-induced ΔAreaSCR negatively correlated with HOMA-IR, us-CRP, liver volume, and liver fat Prepubertal AGA girls had significantly greater BAT activation index as compared to AGA boys; this difference was not observed in SGA subjects Higher BAT activation associated with a lower amount of visceral fat and with a favorable metabolic profile Long-term follow-up is needed to determine whether those differences relate to pubertal timing, and to the development of obesity and metabolic disorders

Brown adipose tissue in prepubertal children: associations with sex, birthweight, and metabolic profile

/pdf/maternal-and-perinatal-risk-factors-for-pediatric-13pzpbdm.pdf

Maternal and Perinatal Risk Factors for Pediatric Nonalcoholic Fatty Liver Disease: A Systematic Review

BACKGROUND Insulin resistance and hepato-visceral (central) fat excess are thought to contribute to an earlier timing of adrenarche/pubarche and puberty/menarche; this earlier timing in turn relates often to a mismatch between prenatal and postnatal weight gain, which can be estimated by calculating the Z-score change from birth weight (BW) to body mass index (BMI) in childhood. METHODS We tested the hypothesis that this calculation may serve as a proxy of insulin resistance and hepato-visceral adiposity in prepuberty by reappraising a cohort of children (mean age, 8.5 years), born appropriate- (AGA, n = 41) or small-for-gestational age (SGA, n = 45), followed since birth (n = 76) or since the age of 3 years (n = 10). Assessments included anthropometry; fasting glucose and insulin; liver volume; and hepatic fat, subcutaneous fat, and visceral fat in the abdominal region (by magnetic resonance imaging [MRI]). RESULTS Z-score change BW-BMI closely associated to central fat (R = 0.74; P < .0001) and insulin resistance (R = 0.71; P < .0001). CONCLUSION These results suggest that Z-score change BW-BMI could be viewed as a simple candidate-marker for hepato-visceral adiposity and insulin resistance in prepubertal children.

Towards a simple marker of hepato-visceral adiposity and insulin resistance: The Z-score change from weight-at-birth to BMI-in-childhood.

Etude d'enfants pesant plus de 2,5 kg a la naissance. Les resultats des estimations de la croissance de la longueur en supuration et du poids des enfants dans le temps sont presentes et compares avec ceux qui ont ete rapportes dans d'autres etudes

Estudio longitudinal de crecimiento y desarrollo de 0 a 2 anos de edad (i). Peso y talla

Toward a Simple Marker of Hepato-Visceral Adiposity and Insulin Resistance:The Z-Score Change from Weight-at-Birth to BMI-in-Childhood

The sequence of prenatal growth restraint and postnatal catch-up growth may lead to hepato-visceral adiposity, insulin resistance and low-grade inflammation before the onset of puberty. In prepubertal children born appropriate for gestational age (AGA) or small for gestational age (SGA), we assessed potential relationships between the aforementioned sequence and liver volume. The study population consisted of 86 children (41 AGA and 45 SGA with catch-up growth; age (mean±s.e.m.), 8.5±0.1 years), recruited into two prospective longitudinal studies. Anthropometry, endocrine–metabolic variables and inflammatory and hepatic markers were assessed, along with liver volume, hepatic adiposity and abdominal fat partitioning (by magnetic resonance imaging). AGA and SGA children differed in hepato-visceral adiposity, but had similar liver volumes. Boys had larger livers than girls, and higher sex hormone binding globulin and inflammation markers. Liver volume correlated with height Z-score, body mass index Z-score, HOMA-IR (homeostasis model assessment-insulin resistance) and with subcutaneous and visceral fat, but not with birth weight Z-score or with hepatic adiposity. Height, visceral fat, gender and HOMA-IR were major determinants of liver volume, together explaining 61% of its variance. The trajectory from prenatal restraint, via postnatal catch-up, to hepato-visceral adiposity and insulin resistance does not appear to be detectably influenced by prepubertal alterations of liver volume. Further follow-up will disclose the potential role of liver volume in the pubertal segment of this trajectory, and whether the augmented fat content and visceral adiposity in SGA subjects is followed by the development of metabolic syndrome and hepatic dysfunction in adulthood.

Liver volume and hepatic adiposity in childhood: relations to body growth and visceral fat.

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Liver volume and hepatic adiposity in childhood: relations to body growth and visceral fat.