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Aspects biologiques, moléculaires et cliniques de l’axe GH/IGF-I pp 151–171Cite as

La croissance de rattrapage consécutive au retard de croissance fœtale entraîne une restauration rapide de la masse grasse, mais sans conséquences métaboliques à l’âge d’un an

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Résumé

Contexte : il a été suggéré que le retard de croissance fœtale (RCF) suivi d’une prise de poids rapide en début de vie pourrait constituer la séquence initiale à l’origine de l’adiposité centrale et de l’insulinorésistance. Cependant, les liens entre croissance fœtale et croissance postnatale initiale avec les modifications métaboliques et anthropométriques qui y ont été associées n’ont guère été explorés.

Méthodologie et principaux résultats : les modifications d’indice de masse corporelle (IMC), d’épaisseur des plis cutanés et de concentrations hormonales ont été surveillées pendant la première année de vie postnatale chez 94 bébés dont la vitesse de croissance fœtale avait auparavant été mesurée par protocole échographique standardisé. Indépendamment de leur poids de naissance, 45 de ces nourrissons avaient présenté un retard de croissance fœtale (RCF+). La croissance des quatre premiers mois de vie s’est caractérisée par des modifications plus importantes du Z-score de l’IMC chez ces bébés RCF+ (+ 1,26 ± 21,2 contre + 0,58 ± 21,17 DS dans RCF-), avec pour résultat la restauration de l’IMC et de la masse grasse aux mêmes valeurs que dans le groupe RCF-, et ce, indépendamment des apports caloriques. À quatre mois, les vitesses de croissance étaient semblables ; les Z-scores de l’IMC ainsi que les pourcentages de masse grasse étaient toujours identiques À douze mois. Que ce soit À quatre ou À douze mois, la vitesse de croissance fœtale s’est avérée être un facteur prédictif indépendant du pourcentage de masse grasse chez les bébés RCF+. À l’âge d’un an, les insulinémies À jeun n’étaient pas différentes, mais le taux de leptine était significativement plus élevé dans le groupe RCF+ (4,43 ± 21,41 contre 2,63 ± 21 ng/ml dans le groupe RCF-).

Conclusion : la croissance de rattrapage initiale est corrélée à la croissance fœtale, quel que soit le poids de naissance. De même, après la naissance, elle est associée à une sensibilité plus importante à l’insuline et à un moindre taux de leptine. La croissance de rattrapage entraîne la restauration de la taille corporelle et des réserves adipeuses sans conséquences nocives à l’âge d’un an sur la composition de l’organisme ou le profil métabolique. Il se pourrait que le taux plus élevé de leptine observé à l’âge d’un an refl ète un équilibre énergétique positif chez les enfants ayant été soumis à un retard de croissance fœtale.

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Authors
  1. J. Beltrand
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  2. R. Nicolescu
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  3. F. Kaguelidou
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  4. R. Verkauskiene
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  5. O. Sibony
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  6. D. Chevenne
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  7. O. Claris
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  8. C. Levy-Marchal
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Editors and Affiliations

  1. Service d’Explorations Fonctionnelles Endocriniennes, Hôpital d’enfants Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012, Paris, France

    Yves Le Bouc

  2. Unité Inserm, UPMC, UMRS 938, France

    Yves Le Bouc

  3. Unité d’endocrinologie, maladie osseuse, génétique et gynécologie médicale, Hôpital des Enfants, 330, avenue de Grande-Bretagne TSA 70054, 31059, Toulouse, France

    Maithé Tauber

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Beltrand, J. et al. (2012). La croissance de rattrapage consécutive au retard de croissance fœtale entraîne une restauration rapide de la masse grasse, mais sans conséquences métaboliques à l’âge d’un an. In: Le Bouc, Y., Tauber, M. (eds) Aspects biologiques, moléculaires et cliniques de l’axe GH/IGF-I. Springer, Paris. https://doi.org/10.1007/978-2-8178-0196-4_13

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  • DOI: https://doi.org/10.1007/978-2-8178-0196-4_13

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