ArticleBMC pediatrics2026
Analysis of metabolic status and risk factors of small for gestational age children with catch-up growth in East China.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeApproximately 85-90% patients with small for gestational age (SGA) experience catch-up growth (CUG) by the age of 2, with their height reaching - 2 standard deviation scores (SDS) or 3% of the height of children of the same age and sex. However, SGA patients with CUG (CUG-SGA) tend to be at a higher risk of developing insulin resistance, obesity, metabolic syndrome, and cardiovascular diseases. This study explored the metabolic conditions of CUG-SGA patients in East China and analyzes the risk factors that may contribute to metabolic issues.
methodsThis multi-center study in East China involved 151 SGA patients aged 2-8 years. Patients were categorized into two groups: CUG-SGA (height not below - 2 SDS among the children of the same age and gender) and NCUG-SGA (SGA patients without CUG, height below - 2 SDS among the children of the same age and gender). Tests for insulin-like growth factor 1 (IGF-1), blood glucose (BG), insulin (INS), triglycerides (TG), total cholesterol (TC), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and leptin (LEP) were conducted after a 12-hour fast. Body mass index (BMI) and homeostatic model assessment for insulin resistance (HOMA-IR) were calculated.
results(1) Out of 151 SGA patients, 82 were girls and 69 were boys. There were 85 patients in CUG-SGA group, including 38 girls and 47 boys. There were 66 patients in NCUG-SGA group, including 44 girls and 22 boys. The height SDS (H-SDS) and weight SDS (W-SDS) of CUG-SGA group were significantly higher than those of NCUG-SGA group (P < 0.05). (2) The level of IGF-1 SDS, ALT, and GGT in the CUG-SGA group were significantly higher than those in the NCUG-SGA group (P < 0.01). The level of W-SDS, LEP, INS, and HOMA-IR in the CUG-SGA group are significantly higher than those of the NCUG-SGA group (P < 0.05). (3) Correlation analysis in SGA patients indicated positive correlations between BG and W-SDS, LEP, and GGT (P < 0.05). INS was positively correlated with IGF-1 SDS, GGT (P < 0.01), and W-SDS (P < 0.05). HOMA-IR was positively correlated with IGF-1 SDS (P < 0.01). TC was positively correlated with LEP (P < 0.05), and TG was negatively correlated with IGF-1 SDS (P < 0.01). (4) After further controlling for confounding factors and performing multiple regression analyses, the results showed that BMI-SDS had a significant positive effect on INS and a significant negative effect on HOMA-IR. IGF-1 had a significant positive effect on INS and HOMA-IR, and a significant negative effect on TG. LEP had a significant positive effect on BG, INS, HOMA-IR, TC, and TG. ALT had a significant negative effect on INS and HOMA-IR, and a significant positive effect on TC and TG. GGT had a significant positive effect on BG, INS, HOMA-IR, TC, and TG.
conclusion(1) IGF-1 SDS was significantly positively correlated with fasting INS (FINS) and HOMA-IR, and exerted a significant positive effect on fasting BG. If IGF-1 levels in CUG-SGA infants remain persistently high, careful monitoring of changes in glucose metabolism is warranted. (2) CUG-SGA patients had higher LEP resistance compared to NCUG-SGA patients, potentially contributing to future metabolic issues. (3) Elevated ALT and GGT levels in SGA patients may warrant close monitoring of glucose metabolism, particularly in CUG-SGA patients.
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