Small-for-gestational-age (SGA) is an indicator of poor fetal growth "programming" an elevated risk of type 2 diabetes in adulthood. Little is known about early life endocrine characteristics in SGA subtypes. Stunting (short) and wasting (skinny) are considered distinct SGA phenotypes in neonatal prognosis.To assess whether SGA infants with stunting or wasting have similar alterations in neonatal endocrine metabolic health biomarkers.A nested case-control study.The 3D (Design, Develop and Discover) birth cohort in Canada.146 SGA (birth weight <10 th percentile) and 155 optimal for gestational age (OGA, 25 th-75 th percentiles) infants. Stunting was defined as birth length <10 th percentile, and wasting as body mass index <10 th percentile for sex and gestational age, respectively.Cord plasma concentrations of insulin-like growth factor I (IGF-I), proinsulin, leptin, high-molecular-weight (HMW) adiponectin and ghrelin.Comparing to OGA infants adjusted for maternal and neonatal characteristics, SGA infants with either stunting only or wasting only had lower cord plasma IGF-I and leptin concentrations. HMW adiponectin concentrations were lower in SGA infants with wasting only (P=0.004), but similar in SGA infants with stunting only (P=0.816). Only SGA infants with both stunting and wasting had substantially lower proinsulin (P<0.001) and higher ghrelin concentrations (P<0.001) than OGA infants.The study is the first to demonstrate that SGA infants with wasting only are characterized by low HMW adiponectin concentrations, while those with stunting only are not. SGA with both stunting and wasting are characterized by low proinsulin and high ghrelin concentrations.
Hua He, Wen-Ting Zhu, Anne Monique Nuyt, Isabelle Marc, Pierre Julien, Rong Huang, Lise Dubois, Shu-Qin Wei, Jun Zhang, Emile Levy, William D Fraser, Zhong-Cheng Luo