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

Anna Kistner1, Alexander Rakow, Lena Legnevall

  • 1Department of Molecular Medicine and Surgery, Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. anna.kistner@ki.se

Acta Paediatrica (Oslo, Norway : 1992)
|August 29, 2012
PubMed

Insights

Children born preterm or small for gestational age (SGA) exhibit altered glucose homeostasis. SGA children may have insulin resistance, while preterm children show signs of hepatic insulin resistance.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Health
  • Developmental Origins of Health and Disease

Background:

  • Prenatal and postnatal environments significantly influence long-term metabolic health.
  • Children born preterm or small for gestational age (SGA) are at increased risk for metabolic disturbances.

Purpose of the Study:

  • To investigate the impact of a compromised early-life environment on glucose homeostasis in children.
  • To compare glucose metabolism in preterm children, SGA children, and those born appropriate for gestational age.

Main Methods:

  • Seventy-seven children were divided into preterm, SGA, and control groups.
  • Anthropometric measurements and fasting blood samples (HbA1c, glucose, insulin, IGFBP-1, IGF-1, lipids) were collected.
  • An oral glucose tolerance test (OGTT) assessed glucose, insulin, and IGFBP-1 dynamics.

Main Results:

  • Preterm and SGA children were shorter and thinner than controls.
  • SGA children showed higher basal insulin and insulin resistance markers (HOMA-IR), with lower insulin sensitivity.
  • Preterm children exhibited attenuated IGFBP-1 suppression during OGTT, indicating potential hepatic insulin resistance.

Conclusions:

  • Elevated fasting insulin in SGA children suggests peripheral insulin resistance.
  • Reduced IGFBP-1 suppression in preterm children points towards hepatic insulin resistance.
  • Early-life growth and gestational age impact childhood glucose metabolism and insulin sensitivity.
Abstract

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