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Large birth size, infancy growth pattern, insulin resistance and β-cell function.

Rong Huang1,2, Yu Dong1,3, Anne Monique Nuyt2

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Large birth size does not impact infant insulin resistance or beta-cell function. However, infant growth patterns, particularly decelerated length growth, significantly affect beta-cell function, suggesting potential long-term metabolic health implications.

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Area of Science:

  • Pediatric endocrinology
  • Metabolic health
  • Developmental origins of health and disease (DOHaD)

Background:

  • Large birth size is a known risk factor for adult type 2 diabetes.
  • The impact of large birth size on infant glucose metabolism and beta-cell function remains understudied.
  • Understanding early-life metabolic programming is crucial for preventing future chronic diseases.

Purpose of the Study:

  • To investigate the association between large-for-gestational-age (LGA) birth size and insulin resistance and beta-cell function in infancy.
  • To identify determinants of insulin resistance and beta-cell function in infancy, focusing on growth patterns.

Main Methods:

  • A nested matched case-control study within the Canadian 3D birth cohort.
  • Comparison of 70 LGA infants with 140 optimal-for-gestational-age (OGA) control infants.
  • Assessment of homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β) at 2 years of age.

Main Results:

  • No significant differences in HOMA-IR or HOMA-β were observed between LGA and OGA infants.
  • Decelerated length growth in early infancy was linked to decreased HOMA-β.
  • Accelerated weight and length growth in mid-infancy were associated with increased HOMA-IR and HOMA-β.
  • Decelerated length growth in late infancy was associated with decreased HOMA-IR and HOMA-β.

Conclusions:

  • Large birth size itself is not associated with altered insulin resistance or beta-cell function in infancy.
  • Infant growth trajectories, particularly decelerated length growth, play a significant role in modulating beta-cell function.
  • Infancy growth patterns may be more critical than birth size in programming long-term metabolic health.