Aspectos endocrinológicos das crianças e adultos nascidos pequenos para a idade gestacional

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Abstract

Crianças nascidas pequenas para a idade gestacional (PIG) apresentam maior risco de permanecerem com baixa estatura na vida adulta. Além disso, estudos recentes têm demonstrado maior risco de doenças cardiovasculares e doenças metabólicas como o diabetes mellitus tipo 2 (DM2) e síndrome X em adultos que nasceram com baixo peso. Neste artigo, a definição e conseqüências do nascimento PIG são revisados, com enfoque sobre as alterações hormonais já descritas em crianças e adultos nascidos PIG.

Translated abstract

Children born small for gestational age (SGA) have a higher risk of short stature than children born at normal size do. Furthermore, reduced birth weight is associated with an increased prevalence of cardiovascular disease, essential hypertension and metabolic disease, particularly type 2 diabetes mellitus. In the present article, the definition and consequences of being born small are reviewed, with focus on the endocrine axes in children and adults born SGA.

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Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth

D Barker, C N Hales, C H D Fall … (1993)

Two follow-up studies were carried out to determine whether lower birthweight is related to the occurrence of syndrome X-Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia. The first study included 407 men born in Hertfordshire, England between 1920 and 1930 whose weights at birth and at 1 year of age had been recorded by health visitors. The second study included 266 men and women born in Preston, UK, between 1935 and 1943 whose size at birth had been measured in detail. The prevalence of syndrome X fell progressively in both men and women, from those who had the lowest to those who had the highest birthweights. Of 64-year-old men whose birthweights were 2.95 kg (6.5 pounds) or less, 22% had syndrome X. Their risk of developing syndrome X was more than 10 times greater than that of men whose birthweights were more than 4.31 kg (9.5 pounds). The association between syndrome X and low birthweight was independent of duration of gestation and of possible confounding variables including cigarette smoking, alcohol consumption and social class currently or at birth. In addition to low birthweight, subjects with syndrome X had small head circumference and low ponderal index at birth, and low weight and below-average dental eruption at 1 year of age. It is concluded that Type 2 diabetes and hypertension have a common origin in sub-optimal development in utero, and that syndrome X should perhaps be re-named "the small-baby syndrome".