ESPE Yearbook of Paediatric Endocrinology

European Journal of Endocrinology (2022)187:15–26 doi: 10.1530/EJE-21-1130

Brief Summary: This study, PROGRAM32, investigated 287 adults mean age 32 years who had participated 10 years earlier in the PROGRAM study on the metabolic and cardiovascular consequences of low birth weight (LBW). The aim was to investigate the adverse metabolic profile of being small for gestational age with spontaneous postnatal catch-up (SGA-CU) compared to age-matched controls born appropriate for gestational age (AGA), and to characterise cardiovascular health in both groups.

LBW is associated with higher risks for type 2 diabetes and cardiovascular disease in adulthood. In the previous PROGRAM study, SGA-CU individuals at age 21 years showed insulin resistance, higher fat mass and an adverse lipid profile.

The current study shows that, 10 years later at age 32 years, SGA-CU adults had lower insulin secretion, higher fat mass in the trunk and an adverse lipid profile compared to AGA. However, these parameters did not worsen over time. Furthermore, gain in weight-SDS from birth to 32 years was associated with higher total FM and visceral FM as well as a higher risk for developing the metabolic syndrome at 32 years. It should be noted that this study considered ‘spontaneous catch-up growth’ – by contrast catch-up growth that is induced by growth hormone therapy has been shown to have beneficial metabolic effects (1).

This is the largest follow-up study of long-term metabolic and cardiovascular health consequences of LBW. The authors use high-quality research tools, including frequently sampled i.v. glucose tolerance test, DXA and MRI, to assess the 170 former LBW individuals.

This study adds to previous evidence that the unfavourable body composition and adverse metabolic profiles consequent to LBW persist into adulthood, particularly in LBW individuals who show spontaneous catch-up growth. Further follow-up studies will be necessary to assess cardiovascular endpoints and the impact on incidence of type 2 diabetes.

Reference: 1. van der Steen M, Smeets CC, Kerkhof GF, Hokken-Koelega AC. Metabolic health of young adults who were born small for gestational age and treated with growth hormone, after cessation of growth hormone treatment: a 5-year longitudinal study. Lancet: Diabetes and Endocrinology 2017 5 106–116.