ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2019) 16 12.6 | DOI: 10.1530/ey.16.12.6

ESPEYB16 12. Type 2 Diabetes, Metabolic Syndrome and Lipid Metabolism Metabolic Syndrome (5 abstracts)

12.6. Early life adversity with height stunting is associated with cardiometabolic risk in adolescents independent of Body Mass Index

Reid BM , Harbin MM , Arend JL , Kelly AS , Dengel DR & Gunnar MR



To read the full abstract: J Pediatr 2018;202:143–149.

Summary: In a case control study of 30 post-institutionalized youths compared with 90 age- and BMI percentile-matched youths living in the Minneapolis-Saint Paul metropolitan area, early life stress, as reflected by height-stunted growth in institutional care, was associated with cardiovascular and metabolic risk in youth, even after their moving into well-resourced homes early in life, and in the absence of increased adiposity.

Comment: It is well known that institutionalization in early childhood results in impaired physical growth.1 This effect seems most pronounced when deprivation coincides with early developmental sensitive periods. Of note, height seems to be more susceptible to the adverse effects of institutional care than weight.2 Even in the presence of adequate nutritional provision, psychosocial deprivation may cause inhibition of growth hormone production and cell resistance to growth factors.3 This is usually reversible upon removal from the depriving environment.

In the current study, we learn about the impact of institutionalization within the first 2 years of life, a critical window for children’s healthy development, on components of the metabolic syndrome. Children who were adopted from orphanages at a mean age of 18 months, and who had a significant growth-delay at adoption, were evaluated at age 13 years, and compared with age- and BMI percentile-matched youths. Independent of body composition and BMI, post-institutionalized children had evidence of arterial stiffening, higher systolic blood pressure, a higher proportion of trunk tissue fat, and higher levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, insulin and HOMA-IR scores; and lower values of total lean mass and gynoid lean mass.

References: 1. Berens AE, Nelson CA. The science of early adversity: is there a role for large institutions in the care of vulnerable children? Lancet. 2015; 386(9991): 388–98.

2. Martins C, Belsky J, Marques S, Baptista J, Silva J, Mesquita AR, et al. Diverse physical growth trajectories in institutionalized Portuguese children below age 3: relation to child, family, and institutional factors. Journal of Pediatric Psychology. 2013; 38(4): 438–48.

3. Dobrova-Krol NA, van Ijzendoorn MH, Bakermans-Kranenburg MJ, Cyr C, Juffer F. Physical growth delays and stress dysregulation in stunted and non-stunted Ukrainian institution-reared children. Infant Behavior & Development. 2008; 31(3): 539–53.

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