E-Mail karger@karger.com Original Paper Horm Res Paediatr 2013;79:103–109 DOI: 10.1159/000347217 Nonalcoholic Fatty Liver Disease in Prepubertal Children Born Small for Gestational Age: Influence of Rapid Weight Catch-Up Growth Maria Felicia Faienza a Giacomina Brunetti b Annamaria Ventura a Mariangela D’Aniello a Tiziana Pepe c Paola Giordano a Mariantonietta Monteduro c Luciano Cavallo a a Department of Biomedical Sciences and Human Oncology, b Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Human Anatomy and Histology and c Department of Diagnostic Imaging, University of Bari ‘A. Moro’, Bari, Italy in SGA prepubertal children who presented a rapid weight gain in postnatal life, and IR plays the key role. An appropriate diet during pregnancy and in the first year of life might pre- vent metabolic syndrome and NAFLD in these subjects. Copyright © 2013 S. Karger AG, Basel Introduction Approximately 6% of newborns at term are small for gestational age (SGA) and present a birth weight and/or length less than −2 standard deviations (SD) from the mean. Most of these children show a catch-up growth dur- ing the first 2 years of life, but approximately 15% of them continue to be short throughout childhood, adolescence and into adulthood [1, 2]. Subjects born SGA are at high risk of developing chronic diseases, including metabolic syndrome (MetS), which have been related to the intra- uterine life environment and linked to epigenetic fetal pro- gramming [3]. Insulin resistance (IR) may be present as early as 1 year of age, and obesity and/or type 2 diabetes are more prevalent in children born SGA than those born ap- propriate for gestational age (AGA) [4]. SGA children also have a predisposition to accumulating fat mass, particu- larly intra-abdominal fat, and they tend to be viscerally ad- ipose even in the absence of overweight [5, 6]. It is not yet Key Words Small for gestational age · Nonalcoholic fatty liver disease · Prepubertal children · Insulin resistance · Visceral fat Abstract Background/Aims: We studied the association of low birth weight with ultrasound-assessed nonalcoholic fatty liver dis- ease (NAFLD) to test the hypothesis that fetal growth retarda- tion followed by a rapid weight catch-up growth might be an additional factor responsible for liver steatosis via insulin re- sistance (IR) and/or intra-abdominal fat. Methods: We en- rolled 23 children born small for gestational age (SGA) with a rapid catch-up growth within the first 6–12 months, and 24 appropriate for gestational age (AGA) children as controls. All children underwent anthropometric, body composition mea- surements and evaluation of liver function tests, lipid profile, plasma glucose and insulin levels. Abdominal ultrasonogra- phy was performed in order to asses liver steatosis and thick- ness of subcutaneous and visceral adipose tissue. Results: NAFLD were observed in 8 out of the 23 SGA children (34.8%). IR and visceral fat were significantly increased in children with hepatic steatosis compared to those without. IR index was significantly related to liver steatosis, independently of body mass index standard deviation score and visceral fat. Conclu- sions: NAFLD should be recognized as an emerging problem Received: October 8, 2012 Accepted: January 17, 2013 Published online: February 28, 2013 HORMONE RESEARCH IN PÆDIATRICS Maria Felicia Faienza, MD Department of Biomedical Sciences and Human Oncology University of Bari ‘A. Moro’, Piazza G. Cesare 11 IT–70124 Bari (Italy) E-Mail mariafelicia.faienza  @  uniba.it © 2013 S. Karger AG, Basel 1663–2818/13/0792–0103$38.00/0 www.karger.com/hrp