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Small for gestational age status is associated with metabolic syndrome in overweight children

Department of Pediatric Nutrition Medicine, Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Dr F Steiner Strasse 5, 45711 Datteln, Germany¹ Division of Health and Social Care Research, King's College London, London, UK

(Correspondence should be addressed to T Reinehr; Email: t.reinehr{at}kinderklinik-datteln.de)

Objective: Small for gestational age (SGA) children are at risk of both later obesity and metabolic syndrome (MetS). However, it is unknown whether obesity or SGA status leads to MetS in these subjects. We hypothesized that overweight children with former SGA status had more present components of the MetS than overweight children with former appropriate for gestational age (AGA) status.

Methods: We analyzed 803 overweight children (4% SGA, mean age 11±0.1 years, body mass index (BMI) 27.3±0.2, SDS-BMI 2.32±0.02) concerning blood pressure, lipids, glucose, and insulin. Oral glucose tolerance tests (oGTT) were performed in all 35 former SGA children and 147 randomly chosen former non-SGA children.

Results: After adjustment for age, sex, pubertal stage, and BMI-SDS, former SGA status was significantly related to blood pressure, triglyceride, insulin, and 2 h glucose levels in oGTT. The MetS prevalence was more than doubled in overweight former SGA subjects (40% MetS) compared with overweight former AGA subjects (17% MetS). The corresponding adjusted odds ratio was 4.08 (95% confidence interval 1.48 to 11.22) for SGA compared with AGA children.

Conclusions: Overweight former SGA children had an increased risk for the components of the MetS compared with overweight former AGA children. Therefore, SGA status seems to be a risk factor for the MetS independently of weight status. Particularly overweight children with former SGA status should be screened for the MetS.