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Is Fat Mass Accretion of Late Preterm Infants Associated with Insulin Resistance?
Nadia Liotto1, Maria Lorella Giannì, Francesca Taroni
1Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione I.R.C.C.S. "Ca' Granda" Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Insights
Late preterm infants have higher fat mass at term but normalize by 3 months. This rapid fat accretion does not appear to disrupt glucose homeostasis or insulin sensitivity in early infancy.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Human Physiology
Background:
- Late preterm infants exhibit significant fat mass accretion from birth to term.
- The long-term metabolic consequences of preterm birth, including metabolic syndrome development, require further investigation.
Purpose of the Study:
- To analyze body composition changes in late preterm infants during the first three months of life.
- To assess insulin sensitivity and resistance in this cohort.
Main Methods:
- An observational, longitudinal study involving 216 late preterm infants.
- Body composition was measured using air displacement plethysmography at term and 3 months corrected age.
- Insulin resistance (HOMA-IR) and sensitivity (QUICKI) were calculated in a subgroup (n=48).
Main Results:
- At term, late preterm infants showed a higher fat mass index compared to term infants.
- By 3 months corrected age, no significant differences in body composition were observed among the groups.
- Glucose, insulin, HOMA-IR, and QUICKI values remained within normal ranges for all infants.
Conclusions:
- Fat mass accretion in late preterm infants does not seem to negatively impact glucose homeostasis in the first three months.
- These findings suggest that early metabolic profiles are not significantly altered by the rapid fat gain observed in this period.
Background:
Late preterm infants show a major fat mass accretion from birth to term. The contribution of preterm birth to the development of the metabolic syndrome is still under investigation.
Objectives:
To evaluate body composition changes in late preterm infants during the first 3 months and to investigate their insulin sensitivity and resistance.
Methods:
We conducted an observational, longitudinal study. A total of 216 late preterm infants underwent body composition assessment using an air displacement plethysmograph at term and at 3 months of corrected age. In a subgroup of infants (n = 48) the blood glucose and insulin concentration were determined at term and insulin resistance (homeostasis model assessment for insulin resistance; HOMA-IR) and sensitivity (quantitative insulin sensitivity check index; QUICKI) were then calculated. The reference group comprised 71 healthy term infants.
Results:
The mean birth weight and gestational age were 2,390 ± 391 g and 35.2 ± 0.8 weeks, respectively. At term the fat mass index (kg/m2) of late preterm infants, born adequate for their gestational age and small for their gestational age, was higher than that of term infants (2.08 ± 0.82 vs. 1.62 ± 0.64 vs. 1.03 ± 0.36, p < 0.005, respectively), whereas at 3 months of corrected age no difference was found among the groups. The mean values of glucose, insulin, HOMA-IR, and QUICKI were within the 5th and 95th percentiles.
Conclusions:
On the basis of these preliminary findings, fat mass accretion of late preterm infants appears not to be associated with perturbation of the glucose homeostasis.
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