Catch-Up Growth in Children Born Small for Gestational Age Related to Body Composition and Metabolic Risk at Six Years of Age in the UK

Objectives:To determine differences in body composition and glucose metabolism according to childhood growth outcomes in a population-based sample of children born small for gestational age (SGA).Methods:A single-centre study of 259 children born SGA identified through hospital records and contacted when aged 4-7 years. Questionnaire data on pre/perinatal history and growth parameters during childhood was collected from the parents, and in a subgroup of 150 children face-to-face assessments were performed, including anthropometric parameters, lean and fat mass, blood pressure, fasting glucose, and C-peptide.Results:Based on the questionnaires, few children had formal clinic follow-up of growth, but 7% of the cohort showed a height and weight of <-2SDS during childhood, and only 2 children met the criteria for growth hormone therapy. Out of the 150 children assessed at a mean age of 6.1 +/- 0.8 years, 122 (81%) showed a catch-up growth in weight. Compared to those without weight catch-up, these children had a higher fat mass index (3.13 +/- 1.36 vs. 2.56 +/- 0.91 kg/m(2),p= 0.04), trunk-to-limb fat mass ratio (0.63 +/- 0.14 vs. 0.56 +/- 0.08,p= 0.002), systolic blood pressure SDS (0.09 +/- 0.71 vs. -0.32 +/- 0.63,p= 0.008), fasting glucose (4.5 +/- 0.5 vs. 4.3 +/- 0.5 mmol/L,p= 0.03), and C-peptide (306 +/- 116 vs. 256 +/- 112 pmol/L,p= 0.08). Among children with weight catch-up growth, those with less height gain had a lower limb lean mass index (4.25 +/- 0.48 vs. 4.48 +/- 0.56 kg/m(2),p= 0.02) and fat mass index (1.57 +/- 0.59 vs. 1.83 +/- 0.77 kg/m(2),p= 0.04).Conclusions:Within this population-based sample of SGA children, catch-up growth in weight was associated with higher abdominal fat mass, blood pressure and glycemia; furthermore, in these children, less height gain was associated with reduced limb lean and fat mass.