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Tian A, Meng F, Li S, Wu Y, Zhang C, Luo X. Inadequate linear catch-up growth in children born small for gestational age: Influencing factors and underlying mechanisms. Rev Endocr Metab Disord 2024; 25:805-816. [PMID: 38763958 PMCID: PMC11294269 DOI: 10.1007/s11154-024-09885-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 05/21/2024]
Abstract
A minority of children born small for gestational age (SGA) may experience catch-up growth failure and remain short in adulthood. However, the underlying causes and mechanisms of this phenomenon are not yet fully comprehended. We reviewed the present state of research concerning the growth hormone-insulin-like growth factor axis and growth plate in SGA children who fail to achieve catch-up growth. Additionally, we explored the factors influencing catch-up growth in SGA children and potential molecular mechanisms involved. Furthermore, we considered the potential benefits of supplementary nutrition, specific dietary patterns, probiotics and drug therapy in facilitating catch-up growth.
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Affiliation(s)
- Anran Tian
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fucheng Meng
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sujuan Li
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yichi Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Cai Zhang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Zhang L, Liu J, Gao D, Li D. Role of ghrelin in promoting catch-up growth and maintaining metabolic homeostasis in small-for-gestational-age infants. Front Pediatr 2024; 12:1395571. [PMID: 38903769 PMCID: PMC11187245 DOI: 10.3389/fped.2024.1395571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/27/2024] [Indexed: 06/22/2024] Open
Abstract
Small-for-gestational age (SGA) has been a great concern in the perinatal period as it leads to adverse perinatal outcomes and increased neonatal morbidity and mortality, has an impact on long-term health outcomes, and increases the risk of metabolic disorders, cardiovascular, and endocrine diseases in adulthood. As an endogenous ligand of the growth hormone secretagotor (GHS-R), ghrelin may play an important role in regulating growth and energy metabolic homeostasis from fetal to adult life. We reviewed the role of ghrelin in catch-up growth and energy metabolism of SGA in recent years. In addition to promoting SGA catch-up growth, ghrelin may also participate in SGA energy metabolism and maintain metabolic homeostasis. The causes of small gestational age infants are very complex and may be related to a variety of metabolic pathway disorders. The related signaling pathways regulated by ghrelin may help to identify high-risk groups of SGA metabolic disorders and formulate targeted interventions to prevent the occurrence of adult dwarfism, insulin resistance-related metabolic syndrome and other diseases.
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Affiliation(s)
- Li Zhang
- Department of Pediatrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jingfei Liu
- Department of Neonatology, Dalian Women and Children’s Medical Group, Dalian, China
| | - Dianyong Gao
- Department of Orthopedics, Lushunkou District People’s Hospital, Dalian, China
| | - Dong Li
- Department of Neonatology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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Nguyen PT, Nguyen PH, Tran LM, Khuong LQ, Nguyen SV, Young MF, Ramakrishnan U. Growth patterns of preterm and small for gestational age children during the first 10 years of life. Front Nutr 2024; 11:1348225. [PMID: 38468696 PMCID: PMC10925699 DOI: 10.3389/fnut.2024.1348225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
Background Preterm and small for gestational age (SGA) remain significant public health concerns worldwide. Yet limited evidence exists on their growth patterns during childhood from low-or middle-income countries. Objectives We investigated the postnatal growth patterns of preterm and SGA compared to term appropriate for gestational age (AGA) children from birth to 10-11y, and examined the impact of birth status on child nutritional status during the school age years. Methods Children born to women who participated in a double-blinded randomized controlled trial of preconception micronutrient supplementation in Vietnam were classified into three groups: preterm AGA (n = 130), full-term SGA (n = 165) and full-term AGA (n = 1,072). Anthropometric data (weight and height) were collected prospectively at birth, 3, 6, 12, 18, 24 months and at 6-7 and 10-11y. We used ANOVA and multiple regression models to examine the differences in growth patterns from birth to 10-11y as well as child undernutrition and overnutrition by birth status. Results Children who were born preterm exhibited rapid postnatal growth, but still had lower HAZ at 1y and 2y and showed catch up to the AGA group at 6y. Compared to those born AGA, SGA infants had higher risk of thinness (BMIZ < -2) at 2y and 6y (adjusted Odds Ratio, AOR [95% CI] 2.5 [1.0, 6.1] and 2.6 [1.4, 4.6], respectively); this risk reduced at 10-11y (1.6 [0.9, 2.8]). The risk of stunting (HAZ < -2) was also 2.4 [1.5, 3.8] and 2.3 times [1.2, 4.1] higher in SGA than AGA group at ages 2y and 6-7y, respectively, with no differences at 10y. Although preterm children had higher rates of thinness and stunting at 2y compared to AGA children, these differences were not statistically significant. No associations were found between preterm or SGA and overweight /obesity at age 10-11y. Conclusion Children who were born term-SGA continued to demonstrate deficits in weight and height during childhood whereas those born preterm showed catch-up growth by age 6-7y. Additional efforts to reduce the burden of these conditions are needed, particularly during school-age and early adolescents when children are exposed to challenging environments and have higher demands for nutrition.
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Affiliation(s)
- Phuong Thi Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Phuong Hong Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
- Department of Nutrition, Diets, and Health, International Food Policy Research Institute, Washington, DC, United States
| | - Lan Mai Tran
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Long Quynh Khuong
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Son Van Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Melissa F. Young
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
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Motte-Signoret E, Saint-Martin C, Bellané-Chantelot C, Portha B, Boileau P. Glucocorticoid-Induced Hyperinsulinism in a Preterm Neonate with Inherited ABCC8 Variant. Metabolites 2022; 12:metabo12090847. [PMID: 36144251 PMCID: PMC9506278 DOI: 10.3390/metabo12090847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
Glucose homeostasis is a real challenge for extremely preterm infants (EPIs) who have both limited substrate availability and immature glucose metabolism regulation. In the first days of life, EPIs frequently develop transient glucose intolerance, which has a complex pathophysiology that associates unregulated gluconeogenesis, immature insulin secretion, and peripheral insulin resistance. In this population, glucocorticoid therapy is frequently administrated to prevent severe bronchopulmonary dysplasia. During this treatment, glucose intolerance classically increases and may lead to hyperglycemia. We report a case of neonatal hypoglycemia that was concomitant to a glucocorticoids administration, and that led to a congenital hyperinsulinism diagnosis in an EPI with a heterozygous ABCC8 variant. The variant was inherited from his mother, who had developed monogenic onset diabetes of the youth (MODY) at the age of 23. ABCC8 encodes a beta-cell potassium channel unit and causes congenital hyperinsulinism or MODY depending on the mutation location. Moreover, some mutations have been observed in the same patient to cause both hyperinsulinism in infancy and MODY in adulthood. In our case, the baby showed repeated and severe hypoglycemias, which were undoubtedly time-associated with the betamethasone intravenous administration. This hyperinsulinism was transient, and the infant has not yet developed diabetes at three years of age. We take the opportunity presented by this unusual clinical presentation to provide a review of the literature, suggesting new insights regarding the pathophysiology of the beta-pancreatic cells’ insulin secretion: glucocorticoids may potentiate basal insulin secretion in patients with ABCC8 mutation.
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Affiliation(s)
- Emmanuelle Motte-Signoret
- Department of Neonatal Intensive Care Unit, Poissy St Germain Hospital, 10 rue du Champ Gaillard, 78300 Poissy, France
- Biologie de la Reproduction, Environnement, Epigénétique et Développement (BREED), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Versailles St Quentin University—Paris-Saclay University, 78350 Jouy-en-Josas, France
- Correspondence: ; Tel.: +331-39-27-52-40; Fax: +331-39-27-44-30
| | - Cécile Saint-Martin
- Department of Medical Genetics, Pitié-Salpêtrière Hospital, Sorbonne University, AP-HP, 75013 Paris, France
| | | | - Bernard Portha
- Unité de Biologie Fonctionnelle et Adaptive, Laboratoire B2PE, CNRS UMR 8251, Campus Grands Moulins, Université Paris Cité, 75205 Paris, France
| | - Pascal Boileau
- Department of Neonatal Intensive Care Unit, Poissy St Germain Hospital, 10 rue du Champ Gaillard, 78300 Poissy, France
- Physiologie et Physiopathologie Endocriniennes, Inserm, Paris-Saclay University, 94276 Le Kremlin-Bicêtre, France
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Papadimitriou A, Marakaki C, Papadimitriou DT. Growth variations with opposite clinical outcomes and the emerging role of IGF-1. Trends Endocrinol Metab 2022; 33:359-370. [PMID: 35331614 DOI: 10.1016/j.tem.2022.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
Normal growth pattern variations [i.e., constitutional advancement and constitutional delay of growth and puberty (CAGP and CDGP)] are the mirror image of each other and are associated with early puberty (EP) and delayed puberty (DP), respectively. Differences between CAGP and CDGP relate not only to auxological characteristics (height, weight) but also to insulin-like growth factor-1 (IGF-1). IGF-1 levels in CAGP are above average whereas in CDGP they are below average, suggesting a role for IGF-1 in the induction of these growth patterns. Herein, we provide data suggesting that early activation of the growth hormone (GH)/IGF-1 axis induces the growth pattern of CAGP. Moreover, we suggest that IGF-1 is a decisive factor for the release of the gonadotropin-releasing hormone (GnRH) inhibition brake that occurs in prepuberty. It is therefore crucial for puberty onset.
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Affiliation(s)
- Anastasios Papadimitriou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Haidari, Athens, Greece.
| | - Chrisanthi Marakaki
- Pediatric Endocrinology Unit, Third Department of Pediatrics, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Haidari, Athens, Greece
| | - Dimitrios T Papadimitriou
- Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Marousi and Endocrine Unit, Aretaeion University Hospital, Athens, Greece
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张 伊. Recent research on the influence of intrauterine growth restriction on the structure and function of the nervous system. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:1184-1189. [PMID: 34753552 PMCID: PMC8580033 DOI: 10.7499/j.issn.1008-8830.2108044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/22/2021] [Indexed: 11/21/2022]
Abstract
Intrauterine growth restriction (IUGR) is caused by many factors, and most newborns with IUGR are small for gestational age (SGA). SGA infants have a relatively high risk of death and disease in the perinatal period, and the nervous system already has structural changes in the uterus, including the reduction of brain volume and gray matter volume, accompanied by abnormal imaging and pathological changes. IUGR fetuses undergo intrauterine blood flow redistribution to protect brain blood supply, and there are still controversies over the clinical effect of brain protection mechanism. SGA infants have a relatively high risk of abnormal cognitive, motor, language, and behavioral functions in the neonatal period and childhood, and preterm infants tend to have a higher degree of neurological impairment than full-term infants. Early intervention may help to improve the function of the nervous system.
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