Weight gain in infancy linked to increased mid-childhood adrenal androgen levels

medwireNews: Children’s weight trajectories between birth and 4 years of age are associated with their dehydroepiandrosterone sulphate (DHEAS) levels at age 7 years, study findings show.

As reported in Clinical Endocrinology, the researchers studied 587 children (52% girls) from the population-based birth cohort Generation XXI who had DHEAS and insulin levels measured at the age of 7 years.

Of these children, 63% were classified as having normal weight gain between birth and age 4, defined as following the 50th weight-for-age percentile curve of the World Health Organization Child Growth Standards. At the age of 7, they had an average BMI standard deviation score (SDS) of 0.4 and DHEAS level of 5.53 µmol/L.

A further 17% of children had continuous weight gain during infancy and childhood, regardless of whether they had low or normal birthweight. These children had an average BMI SDS of 1.1 and DHEAS level of 6.89 µmol/L, which was not significantly higher than that for the normal weight gain category.

Nine percent of children had a low birthweight but caught up to a normal weight for age during infancy (“weight gain during infancy”), with an average BMI SDS of 0.8, and the remaining 11% had persistent weight gain throughout childhood, attaining an average BMI SDS of 2.3 at age 7 years.

These two groups both had significantly higher age 7 DHEAS levels than the normal weight gain group, averaging 7.68 and 8.75 µmol/L, respectively.

The researchers point out that DHEAS levels did not significantly differ between children with weight gain during infancy and those with moderate weight gain throughout childhood, which they attribute to lack of statistical power due to the small number of children in each group.

But they stress that “children following a trajectory of weight gain in the first year of life showed higher androgen secretion than those who gained weight later during childhood, despite their lower fat mass, emphasizing the importance of androgen secretion programming in the prenatal and early postnatal period.”

After adjusting the findings for birthweight and BMI at age 7, only the difference in DHEAS level between the persistent and normal weight gain categories remained significant, and further adjustment for insulin levels at age 7 rendered this nonsignificant.

Average insulin levels at age 7 were markedly higher in the persistent weight gain group than the other groups, at 50.0 versus 26.4–33.3 pmol/L.

“Our results showed that a trajectory of persistent weight gain from birth to 4 years of age can lead to an increased androgen secretion at 7 years old, independently of the child’s current BMI or birth weight, which is probably associated with increased insulin and [insulin-like growth factor] levels and reduced insulin sensitivity”, conclude Rita Santos-Silva (Centro Hospitalar Universitário de S João, Porto, Portugal) and co-researchers.

They add: “Early or more pronounced adrenarche may be a forerunner of polycystic ovarian syndrome and metabolic syndrome in both the persistent weight gain and the low birth weight with rapid catch-up groups.

“These data are entirely in keeping with a predictive risk profile and should act as a warning of the potential consequences of unrestricted childhood weight gain.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

Clin Endocrinol 2022; doi:10.1111/cen.14687
Martin Savage
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