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Licensed Unlicensed Requires Authentication Published by De Gruyter March 29, 2014

Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children

  • Zuzana Blusková EMAIL logo , Ľudmila Koštálová , Peter Celec , Eva Vitáriušová , Zuzana Pribilincová , Marianna Maršálková , Jana Šemberová , Tatiana Kyselová , Anna Hlavatá and László Kovács


Aim: Obesity is the major determinant of metabolic syndrome. Being born small for gestational age (SGA) may be co-responsible. We aimed at evaluating the association between 1. obesity and 2. being born SGA and the presence of endocrine-metabolic abnormalities in prepubertal Slovak children.

Methods: The study included 98 children, aged 3–10.9 years: 36 AGA-born obese children (OB), 31 SGA-born children (SGA) and 31 appropriate for gestational age born non-obese children (AGA). Fasting serum levels of glucose, total cholesterol, LDL, HDL, triglycerides, fT4, TSH, cortisol and insulin were determined. HOMA-IR was calculated. Personal data about birth weight and length and family history were collected. Actual anthropometric measurement was done.

Results: In every group, high prevalence of positive family history of metabolic disorder was found. In comparison with AGA children, OB children were taller (p<0.01) with higher body mass index (BMI) (p<0.001), and had increased insulin levels and homeostasis model assessment for insulin resistance (HOMA-IR) (p<0.001), decreased high-density lipoprotein (HDL) (p<0.001), and a trend to higher cortisol levels (p=0.069) was noted. SGA-born children were shorter (p<0.001), with BMI comparable to the AGA group. They had higher glucose levels (p<0.001), a trend to decreased HDL levels (p=0.085) and increased fT4 levels (p<0.001). A three-fold higher occurrence of metabolic abnormalities was present in obese children and twice more metabolic abnormalities were present in SGA-born children in comparison with AGA-born children.

Conclusions: SGA-born children are more prone to developing endocrine-metabolic abnormalities than non-obese children born AGA, but they are at less risk than obese AGA-born children. We should provide specialized care for obese children already in prepubertal age and pay attention to SGA-born children.

Corresponding author: Zuzana Blusková, Faculty of Medicine, 2nd Department of Paediatrics, Comenius University, University Children’s Hospital, Limbová 1, 833 40 Bratislava, Slovakia, E-mail:


This work was supported by a grant from the Comenius University, Bratislava, Slovakia, No UK/436/2009 and UK/358/2010.

Conflict of interest statement

The authors have no relevant conflict of interest to disclose.


1. de Onis M, Blössner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010;92:1257–64.10.3945/ajcn.2010.29786Search in Google Scholar PubMed

2. Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, et al. Progress and challenges in metabolicsyndrome in children and adolescents: a scientificstatement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation 2009;119:628–47.10.1161/CIRCULATIONAHA.108.191394Search in Google Scholar PubMed

3. Lobstein T, Jackson-Leach R. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatr Obes 2006;1:33–41.10.1080/17477160600586689Search in Google Scholar PubMed

4. Gündüz Z, Dursun İ, Tülpar S, Baştuğ F, Baykan A, et al. Increased endothelial microparticles in obese and overweight children. J Pediatr Endocrinol Metab 2012;25:1111–7.10.1515/jpem-2012-0194Search in Google Scholar PubMed

5. Vitáriusová E, Babinská K, Kostálová L, Rosinský J, Hlavatá A, et al. Food intake, leisure time activities and the prevalence of obesity in schoolchildren in Slovakia. Cent Eur J Public Health 2010;18:192–7.10.21101/cejph.a3607Search in Google Scholar PubMed

6. Vitáriušová E, Koštálová L, Pribilincová Z, Hlavatá A, Kovács L. Occurence of metabolic syndrome and its components in obese children. Čes-slov Pediat 2010;65:55–61.Search in Google Scholar

7. Saenger P, Czernichow P, Hughes I, Reiter EO. Small for gestational age: short stature and beyond. Endocr Rev 2007;28:219–51.10.1210/er.2006-0039Search in Google Scholar PubMed

8. Bateson P, Barker D, Clutton-Brock T, Deb D, D’Udine B, et al. Developmental plasticity and human health. Nature 2004;430:419–21.10.1038/nature02725Search in Google Scholar PubMed

9. Jaquet D, Deghmoun S, Chevenne D, Collin D, Czernichow P, et al. Dynamic change in adiposity from fetal to postnatal life is involved in the metabolic syndrome associated with reduced fetal growth. Diabetologia 2005;48:849–55.10.1007/s00125-005-1724-4Search in Google Scholar PubMed

10. Hernández MI, Mericq V. Metabolic syndrome in children born small-for-gestational age. Arq Bras Endocrinol Metabol 2011;55:583–9.10.1590/S0004-27302011000800012Search in Google Scholar

11. Atabek ME, Pirgon O. Assessment of insulin sensitivity from measurements in fasting state and during an oral glucose tolerance test in obese children. J Pediatr Endocrinol Metab 2007;20:187–95.Search in Google Scholar

12. Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 2005;115:500–3.10.1542/peds.2004-1921Search in Google Scholar PubMed

13. Ghergherechi R, Tabrizi A. Prevalence of impaired glucose tolerance and insulin resistance among obese children and adolescents. Ther Clin Risk Manag 2010;6:345–9.10.2147/TCRM.S12033Search in Google Scholar PubMed PubMed Central

14. Tresaco B, Bueno G, Moreno LA, Garagorri JM, Bueno M. Insulin resistance and impaired glucose tolerance in obese children and adolescents. J Physiol Biochem 2003;59:217–23.10.1007/BF03179918Search in Google Scholar PubMed

15. Valerio G, Licenziati MR, Iannuzzi A, Franzese A, Siani P, et al. Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy. Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy. Nutr Metab Cardiovasc Dis 2006;16:279–84.10.1016/j.numecd.2005.12.007Search in Google Scholar PubMed

16. Romero JB, Briones E, Palacios GC, Castelán K. Subclinical metabolic abnormalities associated with obesity in prepubertal Mexican schoolchildren. J Pediatr Endocrinol Metab 2010;23:589–94.10.1515/jpem.2010.097Search in Google Scholar PubMed

17. Fabricius-Bjerre S, Jensen RB, Færch KV, Larsen TK, Mølgaard C, et al. Impact of birth weight and early infant weight gain on insulin resistance and associated cardiovascular risk factors in adolescence. PLoS One 2011;6:20595.10.1371/journal.pone.0020595Search in Google Scholar PubMed PubMed Central

18. Deng HZ, Li YH, Su Z, Ma HM, Huang YF, et al. Association between height and weight catch-up growth with insulin resistance in pre-pubertal Chinese children born small for gestational age at two different ages. Eur J Pediatr 2011;170:75–80.10.1007/s00431-010-1274-8Search in Google Scholar PubMed

19. Faienza MF, Brunetti G, Ventura A, D’Aniello M, Pepe T, et al. Nonalcoholic fatty liver disease in prepubertal children born small for gestational age: influence of rapid weight catch-up growth. Horm Res Paediatr 2013;79:103–9.10.1159/000347217Search in Google Scholar PubMed

20. Arends NJ, Boonstra VH, Duivenvoorden HJ, Hofman PL, Cutfield WS, et al. Reduced insulin sensitivity and the presence of cardiovascular risk factors in short prepubertal children born small for gestational age (SGA). Clin Endocrinol (Oxf) 2005;62:44–50.10.1111/j.1365-2265.2004.02171.xSearch in Google Scholar PubMed

21. Chen H, Zhang H, Tang W, Xi Q, Liu X, et al. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population. J Pediatr Endocrinol Metab 2013;26:489–96.10.1515/jpem-2012-0299Search in Google Scholar PubMed

22. Aypak C, Türedi O, Yüce A, Görpelioğlu S. Thyroid-stimulating hormone (TSH) level in nutritionally obese children and metabolic co-morbidity. J Pediatr Endocrinol Metab 2013;22:1–6.10.1515/jpem-2012-0384Search in Google Scholar PubMed

23. Radhakishun NN, van Vliet M, von Rosenstiel IA, Weijer O, Beijnen JH, et al. Increasing thyroid-stimulating hormone is associated with impaired glucose metabolism in euthyroid obese children and adolescents. J Pediatr Endocrinol Metab 2013;26:531–7.10.1515/jpem-2012-0302Search in Google Scholar

24. Gertig AM, Niechciał E, Skowrońska B. Thyroid axis alterations in childhood obesity. Pediatr Endocrinol Diabetes Metab 2012;18:116–9.Search in Google Scholar

25. Pacifico L, Anania C, Ferraro F, Andreoli GM, Chiesa C. Thyroid function in childhood obesity and metabolic comorbidity. Clin Chim Acta 2012;413:396–405.10.1016/j.cca.2011.11.013Search in Google Scholar

26. Bagnoli F, Farmeschi L, Nappini S, Grosso S. Thyroid function in small for gestational age newborns: a review. J Clin Res Pediatr Endocrinol 2013;5:2–7.Search in Google Scholar

27. Lem AJ, de Rijke YB, van Toor H, de Ridder MA, Visser TJ, et al. Serum thyroid hormone levels in healthy children from birth to adulthood and in short children born small for gestational age. J Clin Endocrinol Metab 2012;97:3170–78.10.1210/jc.2012-1759Search in Google Scholar

28. de Kort SW, Willemsen RH, van der Kaay DC, van Dijk M, Visser TJ, et al. Thyroid function in short children born small-for-gestational age (SGA) before and during GH treatment. Clin Endocrinol (Oxf) 2008;69:318–22.10.1111/j.1365-2265.2008.03195.xSearch in Google Scholar

29. Kokkoris P, Pi-Sunyer FX. Obesity and endocrine disease. Endocrinol Metab Clin North Am 2003;32:895–914.10.1016/S0889-8529(03)00078-1Search in Google Scholar

30. Douyon L, Schteingart DE. Effect of obesity and starvation on thyroid hormone, growth hormone, and cortisol secretion. Endocrinol Metab Clin North Am 2002;31:173–89.10.1016/S0889-8529(01)00023-8Search in Google Scholar

31. Prodam F, Ricotti R, Agarla V, Parlamento S, Genoni G, et al. High-end normal adrenocorticotropic hormone and cortisol levels are associated with specific cardiovascular risk factors in pediatric obesity: a cross-sectional study. BMC Med 2013;20:11–44.10.1186/1741-7015-11-44Search in Google Scholar PubMed PubMed Central

32. Levitt NS, Lambert EV, Woods D, Hales CN, Andrew R, et al. Impaired glucose tolerance and elevated blood pressure in low birth weight, nonobese, young South African adults: early programming of cortisol axis. J Clin Endocrinol Metab 2000;85:4611–18.Search in Google Scholar

33. Szathmári M, Reusz G, Tulassay T. Low birth weight, adrenal and sex hormones and their correlation with carbohydrate metabolism and cardiovascular physiology, investigated in young adulthood. Orv Hetil 2000;141:1967–73.Search in Google Scholar

34. Todorova B, Salonen M, Jääskeläinen J, Tapio A, Jääskeläinen T, et al. Adrenocortical hormonal activity in 20-year-old subjects born small or appropriate for gestational age. Horm Res Paediatr 2012;77:298–304.10.1159/000338344Search in Google Scholar PubMed

Received: 2013-8-16
Accepted: 2014-2-14
Published Online: 2014-3-29
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

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