Fetal origins of adult disease: a paediatric perspective

Area of Science:

• Pediatric Endocrinology
• Developmental Biology
• Metabolic Health

Background:

• Children born small for gestational age (SGA) or very low birth weight (VLBW) often experience suboptimal intrauterine environments, leading to short stature.
• These growth disparities are associated with distinct alterations in the growth hormone (GH) and insulin-like growth factor (IGF) axes.

Purpose of the Study:

• To investigate the differing endocrine and metabolic consequences of SGA and VLBW in prepubertal children.
• To explore the impact of early life environmental insults on growth and metabolic programming.

Main Methods:

• Comparative analysis of SGA and VLBW children's growth parameters.
• Assessment of the growth hormone (GH) and IGF-I axis in relation to metabolic status.
• Examination of endocrine profiles in children conceived via in vitro fertilization (IVF).

Main Results:

• SGA children exhibited elevated IGF-I levels, suggesting hyperinsulinism or partial IGF-I resistance.
• VLBW children displayed low IGF-I and IGFBP-3 levels, indicative of GH resistance.
• IVF children were taller with increased IGF-I, IGF-II, and IGFBP-3, potentially due to periconceptual environmental effects on gene imprinting.

Conclusions:

• The timing and nature of early life environmental insults differentially affect metabolic and endocrine axes.
• Environmental factors during critical developmental periods can program long-term phenotypic, endocrine, and metabolic outcomes.
• Further research is needed to elucidate the mechanisms linking environmental changes to programmed effects on growth and metabolism.