ENDOCRINE AND METABOLIC CONSEQUENCES OF SMALL FOR GESTATIONAL AGE.

SILVANO L, PEREZ A, MARTIN S, PICOTTO G, MUÑOZ L, PRETEL E, SOBRERO G, ELIAS V, CASTRO L, MERICQ V, TOLOSA DE TALAMONI N, MIRAS M.

Viña del Mar, Chile

Congreso; Annual Meeting of the Sociedad Latinoamericana de Endocrinologia Pediátrica (SLEP); 2006

The early postnatal growth in small for gestational age (SGA) children result from a continuos endocrine-metabolic program, with risk to produce failure in the postnatal growth and development of diseases in adult life. AIM: To analyze the endocrine-metabolic status of SGA children with different growth outcomes. METHODS: 48 healthy prepuberal children born appropriate for gestational age (AGA), mean CA 7.2 y SDS height -0.16 and 49 SGA children divided in 23 SGA with catch up growth, mean CA 7.0 y SDS height -0.88 and 26 SGA without catch up growth (SGAcg-), mean CA 6.1 y SDS height -2.27 were studied. Serum levels of IGF-I, IGF-II, IGFBP3, IGFBP-1, ALS, GHBP, SDHEA, SHBG, leptine, insulin, bone markers, 25 OHD3 and other variables of calcium metabolism were determined and HOMA-IR was calculated. Lumbar and femoral BMD were determined by DEXA (Z-score). Genotypes associated to BMD such as VDR, ER and ColiA1 were analyzed. All parameters were statistically analyzed ANOVA, post hoc tests and corrected by age, sex, and BMI (SPSS 9.0). RESULTS: IGF-I SDS, IGF-II, IGFBP3, ALS values were lower in the SGAcg- as compared to the other groups. No differences were noticed in variables associated to the androgenic pattern and insulin sensitivity. There was a correlation between leptin values adjusted by BMI and GHBP in healthy children (r0.62 p=0.001) and in SGAcg-(r0.49 p=0.027). Femoral BMD was lower in the SGAcg- than AGA, without correlation ship between genotypes and BMD or other studied variables. CONCLUSIONS: the fetal malnutrition and changes in the IGF axis may permanently imprint the organism for poor growth. The possibility that leptin could mediate the effect on GH sensitivity, merits further investigation.