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Preterm born 9-year-olds have elevated IGF-1 and low prolactin, but levels vary with behavioural and eating disorders
A Kistner1,2, E Deschmann3,4, L Legnevall4
1Department of Molecular Medicine and Surgery, Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Stockholm, Sweden.
Insights
Preterm children show higher rates of behavioral and eating disorders linked to lower levels of key hormones like leptin, insulin, and IGF-1. These findings suggest potential hormonal imbalances contributing to these conditions in low birthweight individuals.
Area of Science:
- Pediatric Endocrinology
- Neurobehavioral Disorders
- Developmental Pediatrics
Background:
- Low birthweight, including preterm birth and small for gestational age, is associated with long-term health risks.
- Hormonal dysregulation, particularly involving hypothalamic-associated hormones, may play a role in neurodevelopmental outcomes.
- Understanding these associations is crucial for early intervention and management of behavioral and eating disorders in vulnerable children.
Purpose of the Study:
- To investigate the relationship between hypothalamic-associated hormones and the prevalence of behavioral and eating disorders in children born with low birthweight.
- To compare hormone levels and disorder prevalence between preterm, small for gestational age, and full-term control children.
- To explore potential hormonal underpinnings of neurobehavioral and eating disturbances in this population.
Main Methods:
- A cohort of 100 children (mean age 9.7 years) was studied, comprising preterm (<32 weeks gestation), full-term small for gestational age, and full-term controls.
- Behavioral histories were assessed, and fasting blood samples were analyzed for leptin, insulin, insulin-like growth factor-1 (IGF-I), prolactin, glucagon, and cortisol.
- Statistical analyses were performed to compare hormone levels and disorder prevalence across groups, adjusting for confounders.
Main Results:
- Preterm children exhibited lower prolactin and higher IGF-I levels compared to controls, despite being shorter than predicted.
- Behavioral disorders were more prevalent in preterm children (38%) than controls (10%), as were eating disorders (26% vs. 8%).
- These disorders were associated with lower levels of leptin, insulin, and IGF-I, with combined disorders observed exclusively in the shortest preterm children.
Conclusions:
- Behavioral and eating disorders in preterm children are associated with reduced levels of leptin, insulin, and IGF-I.
- Low prolactin levels in preterm children may indicate increased dopaminergic tone, potentially affecting weight gain.
- Findings suggest possible IGF-I receptor insensitivity as a contributing factor to these observed associations.
Aim:
This study examined the relationship between hypothalamic-associated hormones and behavioural and eating disorders in children with low birthweight.
Methods:
We included 100 children (mean age 9.7 years): 39 were born preterm at <32 gestational weeks, 28 were full-term, but small for gestational age, and 33 were full-term controls. Behavioural histories were analysed, together with fasting blood samples of leptin, insulin, insulin-like growth factor-1 (IGF-I), prolactin, glucagon and cortisol.
Results:
Preterm children had lower prolactin (p = 0.01) and higher IGF-I than controls (p < 0.05, adjusted for confounders), despite being significantly shorter than the predicted target height (p < 0.001). More preterm children displayed behavioural disorders (38% versus 10%, p < 0.001) and eating disorders (26% versus 8%, p < 0.05) than full-term children. These disorders were associated with lower leptin (p < 0.01), insulin (p < 0.05) and IGF-I (p < 0.05), but correlations between these hormones and leptin were similar among the groups. Combined behavioural and eating disorders were only observed in preterm children, who were also the shortest in height.
Conclusion:
Behavioural and eating disorders among preterm children were associated with low leptin, insulin and IGF-1. Low prolactin in all preterm children indicated an increased dopaminergic tonus, which might inhibit body weight incrementation. This raises speculation about IGF-I receptor insensitivity.
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