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Longitudinal changes in insulin sensitivity and secretion from birth to age three years in small- and

V Mericq1, K K Ong, R Bazaes

  • 1Institute of Maternal and Child Research, University of Chile, Santiago, Chile. vmericq@med.uchile.cl

Diabetologia
|November 12, 2005
PubMed

Insights

Small-for-gestational-age (SGA) infants develop insulin resistance linked to rapid early weight gain. This highlights the need for long-term glucose monitoring in SGA individuals.

Area of Science:

  • Endocrinology
  • Metabolic Health
  • Pediatric Growth

Background:

  • Insulin resistance and type 2 diabetes risk may be linked to rapid early postnatal weight gain in small-for-gestational-age (SGA) individuals.
  • Understanding the metabolic trajectory of SGA infants is crucial for early intervention.

Purpose of the Study:

  • To prospectively investigate early changes in insulin sensitivity and secretion in SGA infants compared to appropriate-for-gestational-age (AGA) infants.
  • To determine the relationship between early postnatal weight gain and metabolic changes in SGA infants.

Main Methods:

  • Prospective study of 55 SGA and 13 AGA newborns.
  • Repeated assessment of fasting insulin sensitivity and secretion via intravenous glucose tolerance tests from birth to 3 years.
  • Analysis of weight gain centile crossing and its correlation with metabolic parameters.

Main Results:

  • SGA infants exhibited a transition from lower initial insulin levels to higher fasting insulin levels by age 3.
  • Higher fasting insulin levels in SGA infants correlated with the rate of weight gain (r=0.47, p=0.0003).
  • SGA infants showed reduced glucose disposition index (beta-cell compensation) (p=0.02), persisting after adjusting for weight gain (p=0.009).

Conclusions:

  • SGA infants undergo a significant metabolic shift towards insulin resistance within the first three years.
  • Rapid postnatal weight gain in SGA infants may predispose them to central fat deposition and impaired glucose homeostasis.
  • Reduced compensatory insulin secretion in SGA infants necessitates long-term glucose monitoring for type 2 diabetes risk assessment.
Abstract

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