First and second authors have contributed equally.
Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age
Article first published online: 17 SEP 2012
© 2012 The Author(s)/Acta Pædiatrica © 2012 Foundation Acta Pædiatrica
Volume 101, Issue 12, pages 1217–1224, December 2012
How to Cite
Kistner, A., Rakow, A., Legnevall, L., Marchini, G., Brismar, K., Hall, K. and Vanpée, M. (2012), Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age. Acta Paediatrica, 101: 1217–1224. doi: 10.1111/apa.12005
- Issue published online: 8 NOV 2012
- Article first published online: 17 SEP 2012
- Accepted manuscript online: 25 AUG 2012 09:55AM EST
- Received 29 April 2012; revised 5 August 2012; accepted 22 August 2012.
- Insulin resistance;
- Low birth weight;
- Oral glucose tolerance test
Aim: To evaluate the impact of prenatal or postnatal compromised environment on glucose homoeostasis in children born preterm and appropriate for gestational age or small for gestational age (SGA) at term.
Method: Seventy-seven children (median 9.9 years, range 8.5–10) born at Karolinska Hospital were allocated to three groups: 21 subjects born before 30 weeks of gestational age (preterm), 26 SGA at term and 30 at term with appropriate birth weight (control). Anthropometric measurements were taken, and fasting blood samples for haemoglobin A1c, glucose, insulin, IGFBP-1, IGF-1 and lipid profile were taken. Glucose, insulin and IGFBP-1 samples were taken at 0, 30 and 120 min during an oral glucose tolerance test (OGTT).
Results: Subjects born preterm or SGA were shorter and thinner compared with Controls. After adjustment for body mass index (BMI), the SGA group had higher basal insulin levels (p = 0.029), higher homoeostasis model assessment—insulin resistance (p = 0.012) and lower whole-body insulin sensitivity index (p = 0.007) than Controls. IGFBP-1 decrease during OGTT was attenuated in the Preterm group compared with the Control (p = 0.045) and SGA groups (p = 0.007).
Conclusion: The higher fasting insulin level in the SGA children, adjusted for BMI, could indicate peripheral insulin resistance. Preterm born children had reduced suppression of IGFBP-1 during OGTT, suggesting hepatic insulin resistance.