Clinical review: Constitutional advancement of growth, a.k.a. early growth acceleration, predicts early puberty and childhood obesity.

Abstract

Constitutional advancement of growth (CAG), a.k.a. early growth acceleration, refers to a growth pattern that is characterized by growth acceleration soon after birth, reaching a zenith centile in the first 2 to 4 yr of life and followed by normalization of the growth rate until the onset of puberty, which is usually early. CAG is the mirror image of the growth pattern of constitutional delay of growth and puberty, which is characterized by growth deceleration in the first years of life that is followed by normalization of the growth rate and late onset of puberty. For a child to be considered as presenting CAG, other conditions that lead to early growth acceleration, like genetic tall stature, infant overfeeding, and intrauterine growth restraint, have to be excluded. This review was based on our own data supplemented by relevant articles identified by a PubMed search. Girls with idiopathic precocious puberty almost invariably present the growth pattern of CAG. Moreover, the growth pattern of growth acceleration in the first years of life, i.e. CAG, is also present in children that become obese later in childhood; thus, it may be considered a risk factor for childhood obesity. Given the strong association between childhood obesity and early puberty, especially in girls, infants that present the pattern of CAG have to be monitored for the development of early puberty or/and obesity.