Growth of adipose tissue in infants, children and adolescents: variations in growth disorders.

In order to identify factors important in the growth of adipose tissue, four groups of children were studied. Infants of gestational diabetic mothers demonstrated increased fat cell numbers as early as age two months, a finding which accelerated with increasing age, and which was associated with persistent hyperinsulinemia and increasing obesity. Children with growth hormone deficiency increased their adipose cell number following treatment with exogenous hormone. Patients with the Prader-Willi syndrome, who developed obesity after the age of two, did so primarily via increases in fat cell size. Identical twins who were concordant for birthweight continued to have similar weights and total adipocyte numbers, while in those with discordant birthweights the smaller twin displays lower body weight and adipose cell number. The data indicate that growth hormone and insulin, as well as genetic factors, which may be modified by the in-utero environment, are important determinants of human adipose tissue mass.