Children born small-for-gestational-age exhibit normal body fat but elevated hs-CRP and hepatocellular lipid content

Being born small-for-gestational-age (SGA), is associated with an increased risk of cardiometabolic disease in adulthood. We studied the influence of birth size on hepatocellular lipid (HCL) concentrations in prepubertal children.

A total of 195 prepubertal Caucasian children (4.4-9.7 years) were studied in three cohorts. Twenty-one children were born small-for-gestational-age (SGA), 132 were appropriate-for-gestational-age (AGA), and 42 were large-for-gestational-age (LGA). The outcomes were body fat by dual-energy X-ray absorptiometry (DXA), liver fat MRI and MR spectroscopy (MRS), anthropometric measurements at examination, and biochemical markers of metabolism and inflammation.

MRS revealed higher HCL in SGA children, as determined from the methylene (-CH₂-) resonance (p = 0.02). The high-sensitivity c-reactive protein (hs-CRP) level was also significantly higher in the SGA group than in the AGA (p = 0.01) or LGA groups (p = 0.002). The HCL concentrations were correlated with hs-CRP values in the whole cohort (R = 0.51, p = 0.03), independently of traditional anthropometric markers. Other laboratory parameters were not associated with HCL.

Our study shows a link between SGA status, elevated hs-CRP, and elevated MRS-detectable HCL. MRS may thus be important in identifying prepubertal children at risk for metabolic sequelae.

Prepubertal children born small-for-gestational-age (SGA), although still shorter and leaner than their peers, exhibit elevated liver triglyceride concentrations on proton MR spectroscopy associated with elevated hs-CRP levels. Elevated hs-CRP and liver triglyceride concentrations can be early indicators of pathological metabolic changes associated with later cardiometabolic abnormalities.