Endocrine and metabolic disorders in adolescent and adult patients born small for gestational age.

Valentina Talarico, Angela Nicoletti, Giuseppe Raiola
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Abstract

Children born small for gestational age (SGA), defined by a birth weight and/or length standard deviation score (SDS) of < -2 based on an appropriate reference population, represent a diverse group due to multiple underlying causes of reduced growth. This classification results in a heterogeneous patient cohort. SGA children are prone to endocrinological and metabolic issues not only in childhood but also extending into adolescence and adulthood. This population faces elevated health risks, including persistent short stature, premature adrenarche, pubertal development alterations, neurocognitive problems, and metabolic syndrome. Insulin resistance emerges as a pivotal factor c nht6j7ikontributing to these metabolic complications, prominently featuring obesity, insulin resistance, hypertension, and an increased risk of type 2 diabetes mellitus in adulthood. These medium- to long-term complications significantly impact their quality of life. Growth hormone (GH) therapy for short children born SGA facilitates height normalization throughout childhood, adolescence, and into adulthood. Catch-up growth, however, correlates with heightened risks of obesity, insulin resistance, and metabolic syndrome. Conversely, those without catch-up growth tend to exhibit pronounced short stature and cognitive dysfunction. Given these determinants, comprehensive management and clinical monitoring of SGA children should commence in the neonatal period and extend into adulthood. Recognizing and addressing these challenges early in life can mitigate the long-term impact on health and well-being, emphasizing the importance of a lifelong approach to their care.

青少年和成年小胎儿患者的内分泌和代谢紊乱。
胎龄小儿(SGA)是指出生体重和/或身长标准差评分(SDS)小于-2,以适当的参考人群为基础。这种分类方法导致了患者群体的异质性。SGA 儿童不仅在童年时期容易出现内分泌和新陈代谢问题,而且在青春期和成年期也容易出现这些问题。这一人群面临着更高的健康风险,包括身材持续矮小、肾上腺早熟、青春期发育改变、神经认知问题和代谢综合征。胰岛素抵抗是导致这些代谢并发症的关键因素,主要表现为肥胖、胰岛素抵抗、高血压以及成年后罹患 2 型糖尿病的风险增加。这些中长期并发症严重影响了他们的生活质量。对 SGA 出生的矮小儿童进行生长激素(GH)治疗有助于他们在童年、青春期和成年后身高恢复正常。然而,追赶性生长与肥胖、胰岛素抵抗和代谢综合征的风险增加有关。相反,没有追赶性生长的儿童往往会表现出明显的身材矮小和认知功能障碍。鉴于这些决定性因素,SGA 儿童的综合管理和临床监测应从新生儿期开始,一直延续到成年期。在生命早期就认识到并解决这些挑战,可以减轻对健康和幸福的长期影响,从而强调终生护理的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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