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Pediatrics

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

International Journal of Obesity (2023)Cite this article

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Abstract

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.

Failure to thrive (FTT) is an inadequate growth and weight gain in pediatric patients [1]. The catch-up growth after FTT, however, can evolve into obesity [2]. Renal tubules play an important role in fluid, electrolyte, and acid–base homeostasis [3]. Any flaw along the renal tubules can determine FTT and a treatment of the defective tubular reabsorption can result in a catch-up growth [3]. In patients affected by tubulopathies, we hypothesize that there is an increased risk of overweight and obesity due to rebound following FTT that could complicate these conditions [3,4,5,6]. Our objective was to test our hypothesis in a cohort of children with tubulopathies.

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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

  1. Pediatric Nephrology and Dialysis, Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy

    Claudio La Scola & Andrea Pasini

  2. Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy

    Giulio Rivetti, Anna Di Sessa, Stefano Guarino & Pierluigi Marzuillo

  3. Bologna Health Unit, Community Pediatric Service, Bologna East District, Italy

    Cristina Bertulli

Authors
  1. Claudio La Scola
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  2. Giulio Rivetti
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  3. Cristina Bertulli
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  4. Anna Di Sessa
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  5. Stefano Guarino
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  6. Andrea Pasini
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  7. Pierluigi Marzuillo
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Contributions

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.

Corresponding author

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). https://doi.org/10.1038/s41366-023-01386-2

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