Growth and body composition in very young SGA children
Growth and body composition in very young SGA children
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DOI：
10.1007/s00467-009-1432-2
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发表时间：
2010-04-01
影响因子：
3
通讯作者：
Barrios, Vicente
中科院分区：
文献类型：
--
作者：
Argente, Jesus;Mehls, Otto;Barrios, Vicente
极低出生体重的婴儿有肾单位数量减少的风险，易患肾脏疾病、高血压和代谢综合征。大约3%的婴儿出生时小于胎龄儿（SGA），定义为出生体重和/或身长比平均胎龄儿（GA）低至少2 SD，与这些儿童是否早产或足月出生无关。这些儿童中约有10%没有显示出产后追赶性生长，并且在儿童时期仍然身材矮小。这些婴儿中的大多数不是生长激素（GH）缺乏，但可能有GH抵抗。虽然GH耐药，但大多数患者受益于GH治疗，在儿童期身高正常化，在青春期保持正常的生长速度，并达到正常的成人身高。迄今为止，GH已被证明是安全的，没有显着的不良反应已被证明。患有先天性慢性肾病（CKD）的儿童出生时体重和身长低于正常，约25%的儿童出生时为SGA。矮小和需要生长激素治疗与出生体重和胎龄高度相关。原发性肾脏疾病改变了对GH治疗的反应。需要分析SGA是否是CKD发生高血压、代谢综合征和心血管并发症的额外风险因素。
Infants with a very low birth weight are at risk of a reduced number of nephrons predisposing to kidney disorder, hypertension, and metabolic syndrome. Approximately 3% of infants are born small for gestational age (SGA), defined as birth weight and/or length at least 2 SD below the mean for gestational age (GA), independently of whether these children are born prematurely or at term. About 10% of these children do not show postnatal catch-up growth and remain of short stature during childhood. Most of these infants are not growth hormone (GH)-deficient, but may have GH resistance. Although GH-resistant, the majority of patients benefit from GH therapy, normalize height during childhood, maintain a normal growth velocity during puberty, and attain a normal adult height. To date, GH has been shown to be safe and no significant adverse effects have been demonstrated. Children with congenital chronic kidney disease (CKD) are born with subnormal birth weight and length and about 25% are born SGA. Shortness and need for GH treatment is highly correlated with weight at birth and gestational age. Primary renal disorders modify the response to GH treatment. Analysis of whether SGA is an additional risk factor for CKD regarding the development of hypertension, metabolic syndrome and cardiovascular complications is required.