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Insulin sensitivity in prematurely born adults: relation to preterm growth restraint

Joost Rotteveel1, Mirjam M van Weissenbruch, Jos W R Twisk

  • 1Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands. J.Rotteveel@Vumc.nl

Hormone Research in Paediatrics
|December 8, 2010
PubMed

Insights

Adults born very preterm with normal term weight but restricted growth show lower insulin sensitivity. This difference is linked to current body composition, not birth size alone.

Area of Science:

  • Neonatal Medicine
  • Metabolic Health
  • Endocrinology

Background:

  • Preterm infants face increased risk of developing insulin resistance later in life.
  • The impact of term-birth weight status on adult insulin sensitivity among very preterm individuals is not well understood.

Purpose of the Study:

  • To investigate differences in insulin sensitivity in young adults who were born very preterm.
  • To compare insulin sensitivity between those with small-for-gestational-age (SGA) status, appropriate-for-gestational-age with preterm growth restriction (AGA-PGR), and appropriate-for-gestational-age without growth restriction (AGA-non-PGR) at term.

Main Methods:

  • Utilized the hyperinsulinemic euglycemic clamp technique to measure insulin sensitivity.
  • Studied 21-year-old adults born before 32 weeks of gestation.
  • Categorized participants into SGA (n=17), AGA-PGR (n=12), and AGA-non-PGR (n=28) groups.

Main Results:

  • Insulin sensitivity (M value) was lower in AGA-non-PGR individuals (8.9 mg/kg/min) compared to SGA (11.0 mg/kg/min) and AGA-PGR (10.4 mg/kg/min) groups.
  • These observed differences in insulin sensitivity were no longer significant after adjusting for current body size.
  • Significant differences in linear growth trajectories were noted between AGA-non-PGR and SGA groups, and between AGA-non-PGR and the combined AGA-PGR/SGA groups from infancy to young adulthood.

Conclusions:

  • In adults born very preterm, variations in insulin sensitivity among SGA, PGR, and non-PGR groups are associated with current body composition.
  • Body size and composition, rather than solely birth weight status, appear to be key determinants of insulin sensitivity in this population.
Abstract

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