Fat distribution in short‐stature children born small for gestational age

Abstract

Background: Children born small for gestational age (SGA) with catch-up growth are at high risk for developing obesity; however, the characteristics of body composition, especially fat distribution, before and after growth hormone (GH) treatment in SGA children without catch-up growth remains largely unknown. Methods: Anthropometric characteristics, body composition by dual-energy X-ray absorption, and fat distribution by computed tomography at the umbilical level were examined in 27 prepubertal short-stature children born SGA before and 1 year after GH treatment. Results: Before GH treatment, short-stature SGA children had lean phenotypes, and both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were significantly lower than the age-and sex-matched Japanese reference values. Growth hormone treatment significantly increased height standard deviation scores (SDS), without affecting body mass index SDS. Percentage fat mass decreased with GH treatment; however, fat mass was not altered. Both VAT and SAT were significantly lower than the reference values after GH treatment. The ratio of VAT over SAT significantly increased by GH treatment. Conclusions: Both VAT and SAT were within or below the age-and sex-matched Japanese reference values in short-stature children born SGA before and after GH treatment, indicating that GH treatment may not have unfavorable effects on adiposity in short-stature children born SGA, although it may alter fat distribution.

Growth hormone effect on body composition of children born small for gestational age: a systematic review

“…Previous studies have shown that this increase in lean mass after one year of treatment is positively correlated with gestational age, 19 birth weight, sex, and lean body mass at baseline. 17 According to Boonstra et al (2006) 27 the greater amount of lean mass is also due to the higher intake of calories and carbohydrates.…”

“…In all studies, children started treatment with a lower proportion of fat mass than non-SGA children of the same age and sex, and SGA children remained with a proportion of truncal fat or visceral adipose tissue below the reference values even after the treatment with GH. 16 , 19 , 29 , 30 , 31 …”

“…Previous studies have suggested that the reductions in fat mass percentage by the treatment with GH are not caused by the reduction of the total volume, but by the change in the total body composition, resulting in a lower percentage of fat in the whole body, limbs and trunk. 19 , 31 …”

“…The action of GH on the body composition of SGA children found in the literature is described by the amount of lean mass and total fat mass before and after a given intervention period, as well as the distribution of body fat and the relationship with metabolic and cardiovascular risk. 16 , 17 , 18 , 19 …”

Reductions in estimated glomerular filtration rate during puberty in GH-treated children born small for gestational age are associated with prematurity and low birth weight, not the dosage of GH treatment

“…Fourth, we evaluated renal function using Cr-based eGFR calculation, despite inulin clearance being the gold standard for evaluating renal function. Because decreased muscle mass, which is characteristic of short-statured children born SGA ( 31 ), has been shown to overestimate renal function, additional analysis using serum cystatin C levels may be necessary to provide a more accurate evaluation of renal function. Despite these limitations, we believe that our study is of clinical importance because our results provide new insights into the role of GH treatment in renal function in short-statured children born SGA.…”