Much epidemiological evidence has linked low birth weight with late cardiovascular risk. In order to investigate the effect of intrauterine growth restriction (IUGR) on early atherosclerosis in the fetus, we measured aortic wall thickness (abdominal aortic intima-media thickness: aIMT) by ultrasonography in 15 neonates with IUGR and in 31 neonates considered to be appropriate for gestational age (AGA). Furthermore, we evaluated the relationship between aIMT, serum insulin-like growth factor-I (IGF-I) and low-density lipoprotein (LDL) particle size to investigate the possible effect of these atherosclerosis-related factors on the early atherosclerosis process. The results showed that the mean aIMT was significantly greater in the IUGR neonates than in the AGA neonates (least squares mean ± SE, 537 ± 24.8 vs. 471 ± 17.0 μm, p=0.037). The serum IGF-I levels were lower in the IUGR neonates than in the AGA neonates (27.9 ± 4.3 vs. 42.7 ± 2.9 ng/ml, p=0.009). A significant negative correlation was observed between aIMT and IGF-I in the IUGR neonates (r=-0.646, p=0.009); however, a positive correlation was observed between aIMT and IGF-I (r=0.416, p=0.020) in the AGA neonates. There appeared to be no relationship between aIMT and LDL particle diameter. Atherogenic small, dense LDL was not detected in the IUGR infants. In conclusion, neonates with IUGR have significant aortic thickening with decreased IGF-I, suggesting that prenatal events might predispose them to later cardiovascular risk.

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Prolactinomas are rarely diagnosed in children under the age of 10. A 9-yr-old Japanese boy complained of severe headache and progressive visual disturbance. His growth had been retarded for approximately 3 yr, and his serum PRL level was 811.6 ng/ml. Brain magnetic resonance imaging (MRI) revealed an enlarged pituitary (2.8 × 2.6 × 2.1 cm) with heterogeneous enhancement. He was diagnosed as having a macroprolactinoma accompanied by pituitary apoplexy and growth hormone deficiency. A surgical approach was initially undertaken due to the progressive visual deficits, but a residual tumor was observed, and the level of serum PRL was still high after the surgery. Cabergoline was then started, and the dose was gradually increased to 1.5 mg/wk. The serum PRL level decreased from 138.8 ng/ml to 32.5 ng/ml and 17.7 ng/ml after 5 wk and 19 wk, respectively. At 33 wk of cabergoline treatment, brain MRI demonstrated no evidence of the residual tumor. Thereafter, the serum level of PRL decreased to less than 10 ng/ml, and remission was consistently confirmed on repeated MRI. No adverse events have been observed. The present case suggests that cabergoline can be an effective treatment for prolactinomas in prepubertal children as well as in adults.

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