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Lipolysis and insulin sensitivity at birth in infants who are large for gestational age

Fredrik S E Ahlsson1, Barbro Diderholm, Uwe Ewald

  • 1Department of Women's and Children's Health, Uppsala University, University Children's Hospital, SE-751 85 Uppsala, Sweden. fredrik.ahlsson@kbh.uu.se

Pediatrics
|November 3, 2007
PubMed

Insights

Large for gestational age infants exhibit increased lipolysis and reduced insulin sensitivity at birth, indicating potential long-term metabolic risks. Insulin

Area of Science:

  • Neonatal metabolism
  • Endocrinology
  • Pediatric metabolic health

Background:

  • Infants born large for gestational age (LGA) face risks for neonatal hypoglycemia and later-life obesity, cardiovascular disease, and diabetes.
  • Maternal diabetes is a known risk factor, but metabolic profiles of LGA infants born to non-diabetic mothers require further investigation.

Purpose of the Study:

  • To investigate glucose production, lipolysis, and insulin sensitivity in healthy term LGA infants born to mothers without diabetes.
  • To examine the effect of glucagon administration on energy substrate production in these infants.

Main Methods:

  • Ten healthy term LGA infants (mother without diabetes) were studied postnatally after a 3-hour fast.
  • Gas chromatography-mass spectrometry was used to analyze glucose and glycerol production rates.
  • Insulin sensitivity was assessed using the Homeostasis Assessment Model; glucagon's effect was analyzed in 8 infants.

Main Results:

  • LGA infants showed a glycerol production rate of 12.7 ± 2.9 µmol/kg/min, indicating lipolysis.
  • Mean glucose production rate was 30.2 ± 4.6 µmol/kg/min, with Homeostasis Assessment Model insulin sensitivity at 82% ± 19%.
  • Glucagon increased glucose production and blood glucose, while decreasing lipolysis; insulin increased significantly, inversely correlating with lipolysis reduction.

Conclusions:

  • Newborns who are large for gestational age demonstrate elevated lipolysis and a tendency towards decreased insulin sensitivity shortly after birth.
  • The observed inverse correlation between insulin increase and lipolysis decrease post-glucagon suggests a significant antilipolytic effect of insulin in these infants.
Abstract

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