Gegen Qinliantang Ameliorates Glucose and Lipid Metabolism Disorders in Rat Model of Catch-up Growth by Regulating SIRT1/PGC1α/Nrf1 Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Gegen Qinliantang on glucose and lipid metabolism in the rat model of catch-up growth （CUG） induced by a high-fat diet and the underlying mechanism. MethodA total of 60 SD rats were randomized into a normal control group （n=18） and a modeling group （n=42）. The rat model of CUG was established with a restricted diet followed by a high-fat diet， and the changes of general status and body weight were observed. The levels of fasting blood glucose （FBG）， fasting insulin （FINS）， triglyceride （TG）， and total cholesterol （TC） were measured in 6 rats in each group at the end of the 4th and 8th week， respectively. The homeostasis model assessment of insulin resistance index （HOMA-IR） was calculated， and the insulin sensitivity and body composition changes of CUG rats were evaluated. The successfully modeled rats were assigned into 6 groups： normal control， model， high-， medium-， and low-dose Gegen Qinliantang （2.5， 5， 10 g·kg-1）， and pioglitazone （3.125 mg·kg-1）. The rats were administrated with corresponding drugs by gavage for 6 weeks， and the normal control group and model group were administrated with the same amount of normal saline. During the experiment period， the changes of body weight were recorded， and the FBG， FINS， HOMA-IR， TG， and TC were determined at the end of the experiment. Hematoxylin-eosin （HE） staining was employed to observe the pathological changes of skeletal muscle in rats. The levels of reactive oxygen species （ROS） and malondialdehyde （MDA） in the skeletal muscle were measured strictly according to the manuals of the reagent kits. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was performed to measure the mRNA levels of silencing information regulator 1 （SIRT1）， peroxisome proliferator-activated receptor-gamma coactivator1α （PGC1α）， and nuclear respiratory factor 1 （Nrf1） in the skeletal muscle. Western blot and immunohistochemistry were employed to assess the expression of SIRT1， PGC1α， and Nrf1 in the skeletal muscle. ResultCompared with the normal control group， the model group presented elevated levels of FBG， FINS， TG， and TC （P<0.05， P<0.01）， increased HOMA-IR （P<0.01）， increased diameter of muscle fibers and adipocytes between muscle cells in the skeletal muscle， rising levels of ROS and MDA in the skeletal muscle （P<0.01）， and down-regulated mRNA and protein levels of SIRT1， PGC1α， and Nrf1 （P<0.05， P<0.01）. Compared with the model group， Gegen Qinliantang （especially the medium and high doses） and pioglitazone decreased the body weight， FINS， HOMA-IR， and TG （P<0.05， P<0.01） and reduced interstitial components such as intermuscular fat in the skeletal muscles and the diameter of muscle fibers. Furthermore， the drugs lowerd the levels of ROS and MDA （P<0.05， P<0.01） and up-regulated the mRNA and protein levels of SIRT1， PGC1α， and Nrf1 （P<0.05， P<0.01） in the skeletal muscle. ConclusionGegen Qinliantang can ameliorate the glucose and lipid metabolism disorders and insulin resistance in CUG rats by regulating the SIRT1/PGC1α/Nrf1 signaling pathway.

Risk of Childhood Obesity in Children With High Birth Weight in a Rural Cohort of Northern India

Objective: To compare the risk of early childhood obesity (BMI zscore of ?+2SD) among children of more than 7 years of age with a birth weight of more than 3500 g to a birth weight of 2500- 2999 g. Methods: Retrospective birth cohort study among children of 7 to 10 years of age in 22 villages of Himachal Pradesh with notexposed (birth weight: 2500 to 2999 g) and exposed (> 3500 g) group. Results: A total of 379 and 377 participants were enrolled in notexposed and exposed group, respectively. Adjusted relative risk (aRR) between exposed and high BMI (>+2SD) was 4.9 (95%CI: 1.3-17.5) adjusted for mean age, gender, mean years of schooling, consumption of butter, fruits, vegetables, and indoor playing. Conclusion: High birth weight (>3500 g) increases and normal birth weight decreases the risk of childhood obesity up to five times in rural India.

Research hotspots in post-discharge follow-up management of preterm infants / 中国当代儿科杂志

Preterm infants, especially those born extremely or very prematurely, are at high risk for growth retardation and neurodevelopmental disorders. Regular follow-up after discharge, early intervention, and timely catch-up growth are important guarantees for improving the quality of life of preterm infants and improving the quality of the population. This article provides an overview of the research hotspots in follow-up management of preterm infants after discharge over the past two years, including follow-up modes, nutritional metabolism and body composition follow-up, growth pattern follow-up, neurodevelopmental follow-up, early intervention, etc., in order to provide clinical guidance and research ideas for domestic peers.

Birthweight, postnatal growth and blood pressure in adolescents of low socioeconomic condition: a cohort study in Northeast Brazil

Abstract Objective To verify the influence of low birth weight and rapid postnatal weight gain and associated factors on blood pressure in adolescence in a population of low socioeconomic status, considering that injuries occur in the perinatal period can be predictors of future metabolic changes and are still poorly explored. Methods A cohort study was carried out with 208 adolescents, 78 born with low weight and 130 born with appropriate weight. The infants were followed up during the first six postnatal months and reassessed at 8 and 18 years of age. The independent variables were birthweight and postnatal weight gain. Rapid postnatal weight gain was defined when above 0.67 z score. The co-variables were sex, maternal height and family income at birth, nutritional status at eight years old, socioeconomic conditions, nutritional status, fat mass index, and physical activity level at 18 years. The outcome variable was blood pressure at 18 years old. The bivariate and multivariable logistic regression analysis were realized and p < 0,05 was considered significant. Results The proportion of adolescents with elevated blood pressure was 37.5%. The multivariable logistic regression analysis showed the variables independently associated with a higher chance of elevated blood pressure in adolescence were rapid postnatal weight gain (OR = 2.74; 95% CI 1.22-6.14; p= 0.014), male sex (OR = 4.15; 95% CI 1.66-10.38; p= 0.002) and being physically active (OR = 2.70; 95% CI 1.08-6.74; p= 0.034). Conclusions The rapid postnatal weight gain was a predictor for elevated blood pressure in adolescence, independently of other factors.

Factors for catch-up growth of 12-months low birth weight infants during the period of COVID-19 prevention and control / 上海预防医学

ObjectiveTo investigate the factors influencing the catch-up growth of 12-months low birth weight infants in Suyu District of Suqian City during the period of COVID-19 prevention and control. MethodsAll 301 low birth weight infants were selected with clustered sampling from the database under authorized use， who made their regular check-ups and follow-ups to 12 months in Suyu District of Suqian City from January 2020 to May 2021. Data were collected on infants’ basic information， their birth situation and their weight upon birth and at12 months， while maternal situation during pregnancy and the infants’ postnatal feeding and diseases were investigated with a questionnaire.Z scores were calculated. All infants were divided into the catch-up growth group and the uncompleted catch-up growth group according to whether the △Z score was ≥0.67. The influencing factors were analyzed for catch-up growth of the low birth weight infants during the period of COVID-19 prevention and control. ResultsThere were statistically significant differences in the rate of small for gestational age， preterm birth， intrauterine growth retardation， postnatal nutrition enhancement and feeding mode between the two groups. The results in the multifactor logistics regression analysis showed that intrauterine growth retardation （OR=0.070， 95%CI： 0.015‒0.327） was an obstacle factor for catch-up growth， while postnatal fortified nutrition （OR=6.518， 95%CI 1.215‒34.955） was a promoting factor for catch-up growth. ConclusionThere is catch-up growth in postnatal weight among most of the low birth weight infants. Postnatal fortified nutrition is beneficial to catch-up growth， while intrauterine growth retardation may induce uncompleted catch-up growth.

Improvement in broiler performance by feeding a nutrient-dense diet after a mild feed restriction / Mejora del rendimiento en pollos de engorde mediante una dieta rica en nutrientes tras una ligera restricción alimenticia / Melhoria dos rendimentos de frangos de corte de uma dieta rica em nutrientes após uma restrição ligeira

Abstract Background: The use of early nutrient-restriction programs in broilers can prevent complications such as increased body fat deposition and its consequences. However, feed restriction not always gives the expected results. Objective: To assess the effect of two levels of feed restriction followed by a re-alimentation period with five increasing nutrient levels on growth performance and immune response of broiler chickens. Methods: A total of 330 animals were used. The treatments were: 25 (T25) and 35% (T35) quantitative feed restriction during the starting period, and 0, 2.5, 5, 7.5, 10, and 15% increased energy and protein contents during the growing and finishing periods. Results: For all the T25 treatments, except for T25-0, feed intake (FI) and body weight gain (BWG) were higher, and feed conversion rate (FCR) was lower (p<0.05) compared to the control treatment. In that group, the response of FI and BWG to the increased nutrient density was mostly quadratic (p<0.001), whereas that of FCR was linear (p<0.001). The FI and BWG results were less homogeneous in the T35 treatments, but FCR was lower compared to the control treatment (p<0.05) in all of them. The FCR showed no differences (p>0.05) between treatments during the finishing period. Conclusion: Feeding a nutrient-dense diet after a period of mild feed restriction gives the best results, while increasing nutrient density after a more severe feed restriction does not improve productive results compared to a standard diet. Carcass traits and immune function were not affected by restriction level or nutrient density.

Resumen Antecedentes: El uso de programas de restricción alimenticia temprana en pollos de engorde puede prevenir el incremento de la deposición de grasa corporal y sus consecuencias. Sin embargo, la restricción alimenticia no proporciona siempre los resultados esperados. Objetivo: Investigar los efectos de dos niveles de restricción alimenticia seguida por un período de realimentación con cinco niveles crecientes de nutrientes sobre el rendimiento productivo y la respuesta inmune de pollos de engorde. Métodos: Se utilizaron 330 animales. Los tratamientos fueron: restricción cuantitativa del 25 (T25) y del 35% (T35) durante el periodo de iniciación y aumento de la energía y contenido proteico de la dieta del 0, 2,5, 5, 7,5, 10 y 15% durante los periodos de crecimiento y finalización. Resultados: Para casi todos los T25 el consumo de alimento (FI) y el aumento de peso corporal (BWG) fueron mayores y el índice de conversión (FCR) menor (p<0,05) en comparación con el control. La respuesta del FI y el BWG al aumento de la densidad de nutrientes en este grupo fue mayoritariamente cuadrática (p<0,001), mientras que en el caso del FCR fue lineal (p<0,001). Los resultados del FI y el BWG fueron menos homogéneos en los T35, pero el FCR fue menor que en el control (p<0,05). El FCR no mostró diferencias (p>0,05) entre tratamientos durante el periodo de acabado. Conclusión: La alimentación con una dieta rica en nutrientes después una restricción ligera proporciona los mejores resultados, mientras que el incremento de la densidad de la dieta después de una restricción severa no mejora los resultados productivos en comparación con una dieta estándar. Las características de la canal y la respuesta inmune no se vieron afectadas por el nivel de restricción o la densidad de nutrientes de la dieta.

Resumo Antecedentes: O uso de programas de restrição precoce de nutrientes em frangos de corte tem o potencial de prevenir complicações como o aumento da deposição de gordura corporal e suas consequências. No entanto, a restrição alimentar nem sempre dá os resultados esperados. Objetivo: Investigar os efeitos de dois níveis de restrição alimentar seguidos de um período de re-alimentação com cinco níveis crescentes de nutrientes no rendimento produtivo e na resposta imune de frangos de corte. Métodos: Foram utilizados 330 animais. Os tratamentos foram: restrição quantitativa de 25 (T25) e 35% (T35) durante o período inicial e aumento do conteúdo energético e proteico da dieta de 0, 2,5, 5, 7,5, 10 e 15% durante os períodos de crescimento e finalização. Resultados: Para todos os tratamentos T25, menos para T25-0, consumo de ração (FI) e ganho de peso corporal (BWG) foram maiores e a taxa de conversão (FCR) foi menor (p<0,05) o controle. A resposta do FI e do BWG ao aumento da densidade de nutrientes nesse grupo foi principalmente quadrática (p<0,001), enquanto no caso da FCR foi linear (p<0,001). Os resultados do FI e do BWG foram menos homogêneos nos tratamentos T35, mas o FCR foi menor que no tratamento controle (p<0,05). O FCR não apresentou diferenças (p>0,05) entre os tratamentos durante o período de terminação. Nenhuma tendência clara foi observada no peso relativo dos órgãos linfóides ou na resposta imune devido aos tratamentos testados. Conclusão: A alimentação de uma dieta rica em nutrientes após um período de restrição leve proporcionou os melhores resultados, enquanto o aumento da densidade de nutrientes na dieta após uma restrição severa não melhorou os resultados produtivos em comparação com uma dieta padrão.

Effect of thyroxine on initial catch-up growth in children with hypothyroidism

Background: Hypothyroidism is a common endocrinal cause of growth retardation in children. Following adequate treatment with thyroxine, growth resumes at an accelerated rate which is known as catch-up growth. There are few observational studies from India on the growth parameters following treatment with thyroxine in children with hypothyroidism.Methods: A retrospective study was done in children aged 2-10 years who were newly diagnosed cases of primary hypothyroidism [Total serum Thyroxine (T4) levels <5 'g/dl and serum Thyroid Stimulating Hormone (TSH) levels ?15 'U/ml] and treated with oral thyroxine to attain euthyroid state. Height measured before starting treatment and at the time of follow up visits was noted, the Height Standard Deviation Scores (HSDS) were calculated. The effect of thyroxine on linear growth was studied.Results: There were 23 children who were diagnosed as having primary hypothyroidism of whom 16(69.6%) were females and 7(30.4%) were males. The mean age of the children studied was 7.3'2.3 years. The mean dose of thyroxine required to maintain euthyroid status was 4.6'2.2 'g/kg/day. Mean duration of follow up was 13.7'2.4 months. The initial HSDS was - 2.31'0.9 which improved to a final value of - 1.7'0.76 (?HSDS0.61, p value <0.0001). Mean height velocity was 8.1 cms/year.Conclusions: Following adequate thyroxine replacement therapy catch-up growth occurs and increased growth velocity leads to partial regain of height deficit in the first couple of years of treatment.

Relationship between catch-up growth pattern and neuropsychological development in small-for-gestational-age(SGA) infants / 上海预防医学

Objective To explore the relationship between the catch-up situation of physical development and neuropsychological development in 2-year-old SGA children. Methods A longitudinal follow-up observation was conducted in 185 SGA children who were recruited between January 1, 2016 and January 1, 2017.The height, weight, head circumference and other physical development indicators were measured by unified methods at the age of 24 months.Gesell development scale was used to evaluate the neuropsychological development of catch-up and non-catch-up children. Results In 179 out of 185 SGA children who received physical development examination 56.98%(102/179) had achieved catch-up growth.The rate of abnormal/suspected-abnormal neuropsychological development in the full-term SGA children without Shanghai household registration was higher(P < 0.05).After adjusting the factors of household registration and gestational age, there was no significant difference in neuropsychological development between the catch-up and non-catch-up children(P>0.05). Conclusion SGA children, whose physical development did not reach the catch-up growth at the age of 2 years are not obviously backward in neuropsychological development.Catch-up growth for the children with intrauterine growth retardation mainly shows the positive significance in height and weight.The significance of catch-up growth in neuropsychological development remains to be studied.

Change of BMI in catch-up growth of low birth weight infants aged 0-24 months / 上海预防医学

Objective To investigate the changes and characteristics of body mass index (BMI) of low birth weight infants during catch-up growth within 24 months of life. Methods Using the birth cohort method, 126 low birth weight children (birth weight less than 2 500 g) among the registered and permanent born in Jiading District from January 2016 to December 2016, were enrolled in the study voluntarily.According to the calculation of birth weight and gestational week, 73 children were included in the preterm appropriate for gestational age group and 53 in the full-term small for gestational age group.105 children with gestational age of 37-41 weeks and birth weight of 2 500-3 999 g were included as the control group.The differences of BMI mean and standard deviation were compared between 0-24 months old in three groups, and the changes of BMI curve analyzed between 0-24 months old in boys and girls. Results ① There were 231 infants investigated, who were composed by 111 boys and 120 girls; ② The BMI of the two groups of low birth weight infants at birth and at 2 months old were lower than those of the control group.There was no significant difference between the BMI of preterm appropriate for gestational age group and the control group since the age of 4 months.The BMI of the term small for gestational age group was less than the other two groups between 4 and 18 months of age, the difference was statistically significant (P < 0.05);③ The BMI index of the three groups showed a rapid rise after birth.It peaked at 4-6 months of age, and the BMI value of 7-9 months of age began to fall.Preterm appropriate for gestational age group infants caught up with the BMI of normal-weight infants at 6 months of age.Until the age of 24 months, the BMI of small for gestational age group was still different from normal weight infants, but the difference between the three groups decreased.The rising curves of BMI between boys and girls were similar, but the peak of preterm appropriate for gestational age group girls was lengthened. Conclusion There is a significant catch-up growth for low birth weight infants aged 0-24 months, having a similar trend of normal infants in the late stage.It is necessary to deliver proper breeding education and intervention to the low birth weight infants in their early stages.

Effects of Early Life Nutritional Status on Weight Catch-up Growth，Puberty Initiation and Obesity in Female Rats with Intrauterine Growth Retardation / 中山大学学报(医学科学版)

@#【Objective】To investigate the effects of different nutritional status in early life on weight catch-up，puberty initiation and obesity in rats with intrauterine growth retardation（IUGR）.【Methods】IUGR model of newborn rats was established by limiting diet during pregnancy in SPF rats. Female newborn rats were used in the experiment. IUGR rats were divided into two groups：small litter IUGR group（SL-IUGR）and common feeding IUGR group（CF-IUGR）. Rats of normal birth weight served as normal control group（NC）. The SL-IUGR group was used to simulate overfeeding in lactation period. After weaning，the rats in the three groups were fed with basic diet. The weights were measured at postnatal 1，7，14，21，35，42 and 75 days. The time of vaginal orifice opening（VO）was recorded. The levels of estradiol（E2），luteinizing hormone（LH）and follicle estrogen（FSH）were examined on the 21 d and the 35 d.【Results】The birth weight of IUGR rats was（4.92±0.18）g，which was significantly lower than that in the control group（6.00±0.29 g，P < 0.001）. IUGR rats showed weight growth catch- up on the 14th day. The body weight of SL- IUGR group was higher than that of control group from 14 to 75 d. The body weight of CF-IUGR group lagged behind that of control group from 1 to 75 d，the difference was statistically significant（P < 0.05）. The vaginal opening time of female IUGR rats in SL- IUGR group was （29.88 ± 1.81）d，which was significantly earlier than that of CF- IUGR group（32.03 ± 2.11）days（P = 0.044）. There was a correlation between body weight of the 21 d and vaginal opening time in IUGR rats，Rs = -0.174，P = 0.039. The besity rates of puberty and adulthood of IUGR rats in SL-IUGR group were 28.33% and 21.67%，which were significantly higher than those in CF-IUGR group（7.5%，6.25%；P = 0.001，0.007）. The weight growth rate of adolescent obese IUGR rats at 7 and 21 d was higher than that of non-adolescent obese rats，and the weight growth rate of adult obese IUGR rats at 7 and 35 d was higher than that of non-adolescent obese rats. The difference was statistically significant（P < 0.05）. Binary Logistic regression analysis of vaginal opening time and adult obesity in IUGR rats′ group OR = 0.419，P = 0.24. The time of vaginal orifice opening was not an independent factor of adult obesity. 【Conclusions】The improvement of nutrition level in the early stage of life is beneficial to weight catch-up of IUGR，and the overweight catch-up during lactation can lead to puberty and adulthood obesity of IUGR rats，as well as the advance of vaginal opening time.

Effects of percutaneous varicocele repair on testicular volume: Results from a 12-month follow-up / 亚洲男科学杂志(英文版)

Varicocele is a common finding in men. Varicocele correction has been advocated for young patients with testicular hypotrophy, but there is a lack of morphofunctional follow-up data. We assessed whether percutaneous treatment of left varicocele is associated with testicular 'catch-up growth' in the following 12 months by retrospectively reviewing data from an electronic database of 10 656 patients followed up in our clinic between 2006 and 2016. We selected all young adults (<35 years) with left varicocele who underwent percutaneous treatment, had a minimum of 12 months' ultrasound imaging follow-up, and had no other conditions affecting testicular volume. One hundred and fourteen men (mean±standard deviation [s.d.] of age: 22.8 ± 5.4 years) met the inclusion and exclusion criteria. Left testicular hypotrophy (LTH), defined as a ≥20% difference between left and right testicular volume at baseline, was observed in 26 (22.8%) men. Participants with LTH (mean±s.d.: 14.5 ± 2.7 ml) had lower baseline testicular volume compared to those without LTH (mean±s.d.: 15.7 ± 3.8 ml; P = 0.032). Repeated measures mixed models showed a significant interaction between LTH and time posttreatment when correcting for baseline left testicular volume (β = 0.114, 95% confidence interval [CI]: 0.018-0.210, P = 0.020), resulting in a catch-up growth of up to 1.37 ml per year (95% CI: 0.221-2.516). Age at intervention was also associated with reduced testicular volume (-0.072 ml per year, 95% CI: -0.135 - 0.009; P = 0.024). Percutaneous treatment of left varicocele in young adults with LTH can result in catch-up growth over 1 year of follow-up. The reproductive and psychological implications of these findings need to be confirmed in longer and larger prospective studies.

Comparison of rat models of intrauterine growth retardation established by three different methods / 中国比较医学杂志

Objective Intrauterine growth retardation (IUGR) is characterized by low birth weight of neonates. The aim of this study was to provide a reference for the establishment of IUGR models in scientific research, by comparing the experimental data of different rat models of IUGR established by three commonly-used methods. Methods A total of 20 pregnant rats on the day 0 of gestation were divided into 4 groups, with 5 rats in each group (n=5). Among them, 3 groups of rats were treated with alcohol intervention (group A), uterine artery ligation (group U), and low protein diet (LP group), respectively, to establish rat models of IUGR, and the fourth group served as the normal control group (CON group). Fetal rats were taken through cesarean section on the 20th day of gestation. The body mass, brain mass, placental mass, two-kidney mass, body length and tail length of the fetal rats were measured, and the incidence rate of IUGR, stillbirth rate and their brain to placenta ratio were calculated. The fetal rats in each group were continuously raised and the body mass, perirenal fat pad mass and some organ masses were determined at the 3rd, 6th and 12th weeks. Results The average body mass of the fetal rats in the groups A, U and LP group was significantly lower than that of the normal control group (P＜ 0. 05), and the incidence rate of IUGR of the fetal rats was significantly higher than that of the normal control group (P＜ 0. 05). In addition, the stillbirth rate of pregnant rats in the group U was significantly higher than those of the group A and LP group (P ＜ 0. 05). After raising the rats for 3 weeks, the average body mass of rats in the three experimental groups was significantly lower than that of the normal control group (P ＜ 0. 05), and after raising for 6 weeks, the average body mass in the three experimental groups was still lower than that of the normal control group, but with a non-significant difference (P＞ 0. 05). However, after raising for 12 weeks, the average body mass of the rats in the group A and LP group was significantly higher than that of the normal control group (P ＜ 0. 05). Conclusions Rat models of IUGR can be successfully established either by alcohol intervention, uterine artery ligation or low protein diet. The IUGR model established by low protein diet has the advantages of a higher incidence rate of IUGR and lower stillbirth rate, being more suitable for animal model research. As regards the catch-up growth, the average body mass of the rats during the postpartum period and lactation period after delivered by cesarean section in the group A and LP group is lower than that of the normal control group, but after lactation the rats grow faster than those in the normal control group, indicating the existence of a catch-up growth in the group A and LP group.

Early catch-up growth status and its influencing factors in small for gestational age preterm infants / 中国新生儿科杂志

Objective To study the early physical growth pattern,catch-up growth situation,and the influencing factors of early growth in small for gestational age (SGA) preterm infants.Method Our study was a single center,retrospective study.Criteria for infant inclusion were prematurity,SGA (birth weight less than the 10th percentile of related gender and gestational week,according to Fenton curve 2013),born between January 2012 to October 2015,admitted to our neonatal intensive care unit (NICU) within 24 h after birth,hospitalization more than 7 days,and discharged with complete oral feeding.Corrected age (CA) was used to evaluate growth.According to our follow up plan,anthropometric data (weight,length,head circumference) were collected at corrected full term (40 ± 4 weeks),CA (3 ± 1.5) months and CA (6 ± 1.5) months.Catch-up growth was defined as ΔZ greater than 0.67 compared with that at birth,successful catch-up was defined as anthropometric data higher than 10th percentile in target population.The characteristics and influencing factors were compared between infants with and without catch-up growth.Result Eighty-one SGA preterm infants were involved,45 boys and 36 girls.The average gestational age was (34.6 ± 1.7) weeks,birthweightwas(1617 ± 348) g,birthlengthwas(41.0 ±3.2)cm and head circumference was (29.7 ± 2.0) cm.At corrected gestational age (40 ± 4) weeks,CA (3 ± 1.5) months and CA (6 ± 1.5) months,follow-up rate was 86.4％,66.7％ and 58.0％;catch-up growth in weight was 32.9％,55.6％ and 66.0％;successful catch-up growth in weight was 52.9％,64.8％ and 66.0％.At CA (40 ±4) weeks,there were more boys,sooner recover birth weight,and less patent ductus arteriosus (PDA) in catch-up infants (P ＜ 0.05).At CA (3 ± 1.5) months,catch-up infants had large gestational age,and they were longer at discharge,shorter hospital stay,less PDA,and greater body weight at CA 40 weeks,the difference was statistically significant (P ＜ 0.05).At CA (6 ± 1.5) months,there were difference in hospitalization days,percentile of body weight at CA 40 weeks and percentile of all three anthropometrics at CA (3 ± 1.5) months between catch-up and no catch-up growth infants (P ＜ 0.05).Multiple factor analysis showed that percentile of weight at CA 3 months was the independent risk factor of catch-up growth in weight at CA 6 months (P =0.002,OR =1.221,95％ CI 1.076 ～ 1.385).For every 5 percentile increase in body weight percentile at CA (3 ± 1.5) months of age,the likelihood of complete body weight catch-up growth at CA (6 ± 1.5) months increased 2.965 times (95％ CI 1.480 ～ 5.942).Conclusion Both weight and length of SGA preterm infants showed a trend of rapid gain between corrected gestational age (40 ± 4) weeks to CA (3 ± 1.5) months.The factors that influencing the completion of catch-up growth are different at different age.The weight,length,and head circumference percentile at CA about 3 months are good predictors of growth pattern and situation at CA 6 months for the SGA preterm infants.

Advances in the catch-up growth of preterm infants / 国际儿科学杂志

How to promote premature to achieve more appropriate catch-up growth is the focus issue of neonatal and pediatric primary care research.Growth restriction can increase the risks of growth failure,including physical growth and nervous system development.Excessive catch-up growth is responsible for cardiovascular (hypertension,microvasculopathy),metabolic morbidities (insulin resistance,liver steatosis) in adult even adolescent life.In this paper,the research progress of the growth evaluation,influencing factors and excessive growth in the catch-up growth of preterm infants is reviewed.

Comparison of postnatal catch-up growth according to definitions of small for gestational age infants / 소아과

PURPOSE: Small for gestational age (SGA) is confusingly defined as birth weight (BW) either below 3rd percentile or 10th percentile for infants. This study aimed to compare postnatal catch-up growth between SGA groups according to different definitions. METHODS: Data of 129 infants born with BW below the 10th percentile and admitted to Korea University Anam Hospital and Ansan Hospital were retrospectively reviewed. Height and weight were measured at 6, 12, and 24 months. Results were compared between group A (BW: <3rd percentile) and group B (BW: 3rd–10th percentile). RESULTS: Group A included 66 infants and group B included 63. At age 6 months (n=122), 62.9% of group A and 71.7% (P=0.303) of group B showed catch-up growth in weight. At 6 months (n=69), 55.9% of group A and 80.0% of group B (P<0.05) showed catch-up growth in height. At 12 months (n=106), 58.5% of group A, and 75.5% (P=0.062) of group B showed catch-up growth in weight. At 12 months (n=75), 52.8% of group A and 64.1% of group B (P=0.320) showed catch-up growth in height. Up to age 24 months, 66.7%/80.0% in group A and 63.6%/80.0% in group B showed catch-up growth in weight/height. CONCLUSION: Despite different definitions, there were no significant differences between the two SGA groups in postnatal catch-up growth up to age 24 months, except for height at 6 months. Compared to infants with appropriate catch-up growth, low gestational age and BW were risk factors for failed catch-up growth at 6 months.

Prenatal nicotine exposure aggravated abnormal adrenal function and its gender differences in adult offspring rats with high-fat diet / 中国药理学通报

Aim To explore the alterations of blood corticosterone (CORT) level and adrenal steroidogenic function,as well as its sex specificity in intrauterine growth retardation (IUGR) rats induced by prenatal nicotine exposure (PNE) with high-fat diet (HFD) after birth,and to make clear its mechanism through insulin-like growth factor-1 (IGF-1) signaling pathway.Methods IUGR model was established by PNE (2.0mL · kg-1 · d-1),and the offspring rats were administered with HFD until postnatal week (PW) 24 after weaning.Blood CORT concentration,adrenal steroidogenesis enzymes,expressions of IGF-1 signaling pathway and 11β-HSDs/CR system were tested.Results Compared with HFD control group,the CORT concentration in male offspring of PNE group represented a decrease trend,while an increase trend in female;the expressions of adrenal steroidogenesis enzymes (such as StAR,3β-HSD and P450cll) in male offspring decreased,while increased in female offspring (such as SF-1 and P450c21);the expressions of IGF-1 signalling pathway (IGF-1 and IGF-1R) in male offspring increased,and they significantly increased in female offspring;the expression levels of 11 β-HSD2 and GR decreased,but 11β-HSD1/11β-HSD2 ratio was enhanced in male PNE group,while in female PNE group,the corresponding gene expressions increased.Conclusions PNE could induce abnormal alterations of adrenal steroidogenic function,and exhibit apparent gender differences.The potential mechanism is related to low adrenal steroidogenesis function programming induced by nicotine and catch-up growth mediated by IGF-1 after birth.

Diagnosis and treatment of small-for-gestational-age infants based on clinical practice guideline and expert consensus / 基础医学与临床

Infants of small-for-gestational-age have high rate of mortality and morbidity in perinatal period , high risk of metabolic syndrome in adult .However , there is a lack of consensus about the diagnosis and treatment of small-for-gestational age in China .We make a literature review for the definition , risk factors, growth hormone ther-apy, evaluation before and after growth hormone therapy , short-time and long-time complications of small-for-gesta-tional-age in all the clinical practice guideline and expert consensus available all over the world , aiming at providing useful information in clinical practice .

Effect of energy-enriched formula for catch-up growth in malnourished infants after congenital heart disease surgery / 中华临床营养杂志

Objective To investigate the efficacy and safety of enriched-calorie formula in post-operative infants with congenital heart disease and malnutrition.Methods All malnourished infants less than 6 months diagnosed congenital heart disease: ventricular septal defect and had undergone surgery in Guangzhou Women and Children`s Medical Center from December 1,2014 to May 30,2015 were included in this study.All cases were randomly divided into intervention group(energy-enriched formula,intervention group)and control group(standard formula,control group)for enteral nutrition intervention and observed for 3 months.Body mass,body length,upper arm circumference,blood prealbumin(PA),retinol binding protein(RBP),and B-terminal pro-brain natriuretic peptide(NT-proBNP)were measured before and after ICU,after discharge,and 1 month and 3 months after operation.Results Fifty-one cases were in intervention group and 50 cases in control group,respectively.There were no significant differences in body mass,body length,arm circumference,PA,RBP,mean enteral nutrition starting time,mechanical ventilation time,length of ICU stay,hospitalization time,and average fluid intake between the two groups(all P>0.05).The average caloric intake in intervention group was significantly higher than in control group [(437.24±6.68)kJ vs.(312.43±86.22)kJ,P=0.001].There was no significant difference in NT-proBNP,PA,and RBP at different time points between the two groups(all P>0.05).The improvement of nutrition in intervention group was significantly higher than that in control group at 1 month(25.0％vs.4.9％,P=0.011)and 3 months(64.1％vs.15.7％,P<0.001)after operation.Body mass increased in intervention group [(0.067±0.348)kg] compared with that in control group,and decreased [(0.125±0.425)kg] in control group(P=0.015).Body weight[(5.46±1.36)kg vs.(4.80±1.01)kg,P=0.008],weight for age Z score(WAZ)(-2.79±1.28 vs.-3.75±1.27,P<0.001),and height for weight Z score(WHZ)(-2.47±1.43 vs.-3.62±1.77,P=0.001)one month after surgery were significantly higher than those before operation.Body weight [(6.78±1.42)kg vs.(5.72±1.01)kg,P<0.001] arm circumference [(12.80±1.17)cm vs.(12.00±0.90)cm,P<0.001],WAZ(-1.60±1.17 vs.-3.10±1.40,P<0.001),height for age Z score(HAZ)(-1.41±1.63 vs.-2.10±1.41,P=0.034),and WHZ(-0.86±1.31 vs.-2.59±2.13,P<0.001)of the two groups at 3 months postoperative were significantly higher than those before operation,and the growth rate of intervention group was faster than control group.There were no significant adverse reactions in both groups.Conclusion Calorie-enriched formula powder can help malnourished infants to catch up after congenital heart disease surgery.

The analysis of the glycometabolism in the non-catch-up growth children born small for gestational age / 国际儿科学杂志

Objective To investigate the insulin sensitivity in children born small for gestational age without catch-up growth.Methods We investigated 439 outpatients in pediatric department of the Third Hospital of Peking University with diagnosis of short stature from August 2008 to August 2016.Two groups were divided based on their diagnosis as born small for gestational age group(SGA)with 218 patients and idiopathic short stature group(ISS)with 221 patients.Fasting blood-glucose,fasting insulin,fasting insulin/fasting blood-glucose,islet beta-cell function(HOMA%),homeostasis model assessment-insulin resistance(HOMA-IR)were analyzed in two groups.Results Hierarchy based on age and sex in SGA and ISS.No significant difference was observed in preadolescent boys with fasting blood-glucose(4.7±0.6 vs 4.8±0.6,P=0.678),fasting insulin(5.1±4.0 vs 4.3±4.7,P=0.345),fasting insulin/fasting blood-glucose,HOMA%,HOMA-IR.No significant difference was observed in preadolescent girls with fasting blood-glucose(4.5±0.5 vs 4.6±0.5,P=0.828),fasting insulin(4.7±3.5 vs 4.5±3.3,P=0.603),fasting insulin/fasting blood-glucose,HOMA%,HOMA-IR.No significant difference was observed in adolescent boys with fasting insulin(5.9±4.3 vs 6.0±4.5,P=0.958),fasting blood-glucose(5.0±0.8 vs 4.9±0.5,P=0.176),fasting insulin/fasting blood-glucose,HOMA%,HOMA-IR.No significant difference was observed in adolescent girls with fasting blood-glucose(4.9±0.6 vs 4.8±0.4,P=0.141),fasting insulin(7.5±6.4 vs 7.4±8.6,P=0.448),fasting insulin/fasting blood-glucose,HOMA%,HOMA-IR.Conclusion The insulin sensitivity were in good condition in children born small for gestational age without catch-up growth.

Relationship between catch-up growth of premature infants and insulin resistance / 中华实用儿科临床杂志

Objective To investigate the effect of catch-up growth on insulin resistance(IR) through analysis of biochemical and metabolic indices in premature infants.Methods There were 126 infants admitted in the Department of Neonatology,the Affiliated Hospital of Guiyang Medical College from December 2010 to December 2013 [factors which might affect the secretion of insulin(INS),C peptide and insulin-like growth factor-1 (IGF-1) were excluded].According to gestational age and birth weight,babies were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group.And according to the age on follow-up,babies were divided into 1-to-6-month-old group,7-to-12-month-old group and ≥ 1-to-3 year-old group.All cases had 6 mL peripheral venous blood sampled in the early morning during fasting in the first week,and 6,12,24,36 months after birth.They were tested for levels of INS,C peptide,IGF-1,triglyceride (TC),total cholesterol (TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood-glucose (FBG),albumin,prealbumin and creatinine respectively.At the same time,the physical parameters were measured,including weight,body length,and calculated insulin resistance index (IRI),Ponderal index,weight standard deviation score (SDS),and length SDS.Results (1) Catch-up growth after premature birth occupied 65.6％ (63/96 cases),whereas no catch-up growth occupied 34.4％ (33/96 cases) of study snbjects,and among them catch-up growth of 37 cases was better (8 cases of SGA,29 cases of AGA),26 cases showing catch-up growth(7 cases of SGA,19 cases of AGA),33 cases without catch-up growth(11 cases of SGA,22 cases of AGA).No statistical significance was found in the distribution of catch-up growth between SGA group and AGA group(P ＞ 0.05).(2) The LgIRI,LgINS of group with good catch-up growth was significantly lower than the group with no catch-up growth group (F =3.55,3.47) in infancy,but the level of IGF-1 and prealbumin was higher than that of no catch-up growth group (F =3.55,4.94),the difference had statistical significance (P ＜ 0.05) ; the better catch-up growth was associated with higher IGF-1 and prealbumin,but with lower LgIRI.(3) The risk factors for insulin resistance were SGA (OR =7.904,P =0.001),low birth weight ＜ 1 500 g (OR=8.737,P=0.019),and no catch-up growth (OR=11.706,P=0.000).Conclusions The better catch-up growth in infancy is associated with higher IGF-1 and prealbumin,but lower IR.The risk factors of IR include SGA,low birth weight and no catch-up growth,and the last being the major factor.