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Updated: Jul 31, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Small-for-gestational-age and predictors of HOMA indices, leptin and adiponectin in infancy
Rong Huang1,2, Hua He3,4, Anne Monique Nuyt2
1Lunenfeld-Tanenbaum Research Institute, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Faculty of Medicine, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Insights
Infants born small-for-gestational-age (SGA) show normal metabolic health biomarkers at age two. However, SGA infants may have a dysfunctional adiposity-adiponectin feedback loop, indicated by a BMI-adiponectin association.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Fetal Growth Research
Background:
- Small-for-gestational-age (SGA) is an indicator of impaired fetal growth.
- Metabolic health in infancy is crucial for long-term well-being.
- Understanding factors influencing infant metabolic health is essential.
Purpose of the Study:
- To determine if small-for-gestational-age (SGA) impacts metabolic health biomarkers in infancy.
- To identify predictors of metabolic health in SGA infants.
- To explore insulin resistance, beta-cell function, leptin, and adiponectin levels in SGA infants.
Main Methods:
- A nested matched (1:2) prospective observational study.
- Compared 65 SGA infants with 130 optimal-for-gestational-age (OGA) control infants.
- Assessed homeostasis model assessment of insulin resistance (HOMA-IR), beta-cell function (HOMA-β), leptin, and adiponectin at age 2 years.
Main Results:
- No significant differences in HOMA-IR, HOMA-β, leptin, or adiponectin between SGA and OGA infants.
- Female sex and accelerated length growth were linked to higher HOMA-IR.
- Caucasian ethnicity and decelerated weight growth were linked to lower HOMA-IR.
- A positive association between BMI and adiponectin was observed in SGA infants.
Conclusions:
- Infants born SGA exhibit normal insulin resistance, secretion, leptin, and adiponectin levels at age two.
- A novel finding suggests a potentially dysfunctional adiposity-adiponectin feedback loop in SGA infants.
- This dysfunction may relate to altered adiposity regulation during infancy in SGA individuals.
Aim:
To assess whether small-for-gestational-age (SGA) - an indicator of poor fetal growth, may affect metabolic health biomarkers in infancy and explore the predictors.
Methods:
This was a nested matched (1:2) prospective observational study of 65 SGA (birth weight < 10th percentile) and 130 optimal-for-gestational-age (OGA, birth weight 25th-75th percentiles, control) infants in the 3D birth cohort with subjects recruited in Canada from 1 May 2010 to 31 August 2012. The outcomes included homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β), circulating leptin and adiponectin concentrations at age 2 years.
Results:
HOMA-IR, HOMA-β, leptin and adiponectin concentrations were similar in SGA versus OGA infants. Female sex and accelerated growth in length during mid-infancy (3-12 months) were associated with higher HOMA-IR. Caucasian ethnicity and decelerated growth in weight during late infancy (12-24 months) were associated with lower HOMA-IR. Current BMI was positively associated with circulating adiponectin in SGA infants only (+13.4% [4.0%-23.7%] per BMI z score increment).
Conclusion:
Insulin resistance and secretion, circulating leptin and adiponectin levels were normal in SGA subjects in infancy at age 2 years. The novel observation in SGA-specific positive association between current BMI and circulating adiponectin suggests dysfunctional adiposity-adiponectin negative feedback loop development during infancy in SGA subjects.
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