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Failure to thrive in children with tubulopathies increases the risk of overweight later in life


Failure to thrive (FTT) is an inadequate growth in young children. It can increase the risk of overweight or obesity later in life. Patients with renal tubulopathies can present FTT due to solute losses in the urine. We aimed to test our hypothesis that children with tubulopathies have an increased risk of overweight and obesity due to rebound following FTT that could complicate these conditions. We enrolled 26 patients with tubulopathies and evaluated for the first time within the first 12 months of life (mean age: 4.8 months ± 2.6 SDS). FTT was evident in 17 out of 26 patients (65.4%). The mean age at the last follow-up was 14.1 years ± 5.5 SDS. The mean age at overweight/obesity onset was 9.0 years ± 3.6 SDS. The prevalence of overweight/obesity was 73.1% (19/26). Among the patients with FTT, 15 (88.2%) developed overweight/obesity compared to 4 out of the 9 patients (44.4%) without FFT (p = 0.028). The presence of FTT determined an OR for obesity/overweight of 9.4 (95% CI: 1.3–67.6; p = 0.026). FTT continued to be significantly associated with obesity/overweight also after adjustment for preterm birth and birth weight <10th percentile (OR = 23.3; 95% CI: 1.95–279.4; p = 0.01). In conclusion, in our series, patients with tubulopathies presented an increased risk of overweight/obesity due to the FTT that can complicate these conditions.

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Fig. 1: Cumulative proportion of children developing overweight/obesity evaluated by Kaplan–Meier analysis.
Fig. 2: Trajectories of mean BMI values.

Data availability

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to the presence of information that could compromise research participant privacy.


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Authors and Affiliations



Conceptualization: CLS, PM; methodology: ADS, GR; software: CB, AP; validation: SG, PM; formal analysis: ADS, PM; investigation: AP, SG, CLS; data curation: PM, CLS; writing—original draft preparation: ADS, PM; writing—review and editing: CLS, PM, GR; supervision: PM. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Pierluigi Marzuillo.

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The authors declare no competing interests.

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This was a retrospective study; however, each patient or their parents signed a generic consent to use anonymous data deriving from their clinical charts.

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La Scola, C., Rivetti, G., Bertulli, C. et al. Failure to thrive in children with tubulopathies increases the risk of overweight later in life. Int J Obes (2023).

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