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Updated: Jul 6, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Visceral adiposity without overweight in children born small for gestational age
Lourdes Ibáñez1, Abel Lopez-Bermejo, Larisa Suárez
1Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues, Barcelona, Spain. libanez@hsjdbcn.org
Insights
Children born small for gestational age (SGA) often experience catch-up growth but may develop visceral fat and low adiponectin levels. Weight control alone may not be enough to prevent these metabolic issues.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Body Composition Analysis
Background:
- Children born small for gestational age (SGA) typically exhibit catch-up growth and may become overweight by age six.
- Current weight control strategies' effectiveness in preventing visceral fat accumulation and hypoadiponectinemia in SGA children is unclear.
Purpose of the Study:
- To investigate whether weight control is sufficient to prevent visceral fat excess and hypoadiponectinemia in children born SGA with spontaneous catch-up growth.
- To compare body composition and metabolic markers between SGA and appropriate for gestational age (AGA) children at age six.
Main Methods:
- A university hospital setting was used for the study.
- Sixty-four children (32 SGA, 32 AGA), matched for gender, height, weight, and BMI at age six, were included.
- Measurements included lean and fat mass via absorptiometry, and abdominal subcutaneous and visceral fat via MRI. Fasting insulin, IGF-I, adiponectin, leptin, and visfatin were also assessed.
Main Results:
- Despite comparable total lean and fat mass, leptin, and visfatin levels, SGA children exhibited higher fasting insulin and IGF-I.
- SGA children presented significantly lower high molecular weight adiponectin levels.
- A notable shift towards increased visceral fat and decreased subcutaneous abdominal fat was observed in SGA children, with fasting insulin being a key determinant.
Conclusions:
- Children born SGA remain prone to visceral adiposity and hypoadiponectinemia, even without being overweight.
- Interventions beyond standard weight control are necessary to normalize body composition and metabolic homeostasis in SGA children.
Context:
Children born small for gestational age (SGA) tend to develop catch-up growth in infancy and become overweight by the age of 6 yr. Weight control is advocated as a preventive measure, but it is unknown whether such control suffices to prevent visceral fat excess and hypoadiponectinemia.
Setting:
The study was performed at a university hospital.
Study Population And Design:
A total of 64 children (32 matched pairs) aged 6 yr, of whom 32 were born appropriate for gestational age and 32 were born SGA, and had subsequently developed spontaneous catch-up growth were included in the study; matching was performed for gender, height, weight, and, thus, body mass index.
Main Outcomes:
Fasting insulin, IGF-I, high molecular weight adiponectin, leptin, visfatin, and lean and fat mass were calculated by absorptiometry, and abdominally sc and visceral fat by magnetic resonance imaging.
Results:
After strict matching, SGA children had a total lean mass, total fat mass, leptinemia, and visfatinemia comparable to those in the appropriate for gestational age children, but they still had higher fasting insulin and IGF-I levels (P < 0.01), much lower high molecular weight adiponectin levels (P < 0.0001), and a striking shift from abdominally sc to visceral fat (P < 0.0001). Fasting insulin (r = 0.52; P < 0.00001) was a major determinant of visceral fat in boys and girls, explaining 28% of its variance.
Conclusions:
SGA children tend to be viscerally adipose and hypo-adiponectinemic, even if they are not overweight. Therefore, measures beyond weight control seem to be needed to allow most SGA children to normalize their body composition and endocrine-metabolic homeostasis.
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