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Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age

Authors

  • Anna Kistner,

    1. Department of Molecular Medicine and Surgery, Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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    • First and second authors have contributed equally.

  • Alexander Rakow,

    1. Department of Women and Child Health, Karolinska Institutet, Neonatal Unit, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden
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    • First and second authors have contributed equally.

  • Lena Legnevall,

    1. Department of Women and Child Health, Karolinska Institutet, Neonatal Unit, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden
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  • Giovanna Marchini,

    1. Department of Women and Child Health, Karolinska Institutet, Neonatal Unit, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden
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  • Kerstin Brismar,

    1. Department of Molecular Medicine and Surgery, Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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  • Kerstin Hall,

    1. Department of Molecular Medicine and Surgery, Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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  • Mireille Vanpée

    1. Department of Women and Child Health, Karolinska Institutet, Neonatal Unit, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden
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Anna Kistner, M.D., Ph.D., Department of Molecular Medicine and Surgery, M1:3, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. Tel: +46-8-51779153 | Fax: +46-8-51773658 | Email: anna.kistner@ki.se

Abstract

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.

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