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Insulin resistance prior to term age in very low birthweight infants: a prospective study

Itay Zamir1, Elisabeth Stoltz Sjöström2, Johannes van den Berg3

  • 1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden itay.zamir@umu.se.

BMJ Paediatrics Open
|February 10, 2024
PubMed

Insights

Very low birthweight infants show hormonal signs of insulin resistance. Lower gestational age and high blood sugar are linked to increased markers of insulin resistance in these vulnerable infants.

Area of Science:

  • Neonatal endocrinology
  • Metabolic disorders in preterm infants

Background:

  • Very low birthweight (VLBW) infants often experience glucose dysregulation.
  • Understanding the hormonal profile is crucial for managing metabolic complications in preterm neonates.

Purpose of the Study:

  • To investigate the glucose-related hormone profile in VLBW infants.
  • To determine the association between neonatal hyperglycemia and insulin resistance during hospitalization.

Main Methods:

  • Prospective observational study of 48 VLBW infants in Swedish neonatal units.
  • Measured plasma hormone concentrations (insulin, C-peptide, ghrelin, GLP-1, glucagon, leptin, resistin, proinsulin) and calculated insulin resistance indices (HOMA2, QUICKI) on DOL 7 and 36 weeks PMA.
  • Analyzed associations between gestational age, hyperglycemia, and hormonal markers.

Main Results:

  • Lower gestational age correlated with higher glucose, insulin, C-peptide, proinsulin, leptin, ghrelin, resistin, GLP-1, increased HOMA2, decreased QUICKI, and lower proinsulin:insulin ratio.
  • Hyperglycemic infants exhibited higher glucose, C-peptide, insulin, leptin, proinsulin, and lower QUICKI compared to normoglycemic infants.
  • Elevated glucose and proinsulin on DOL 7, along with a higher insulin:C-peptide ratio and lower QUICKI, predicted longer hyperglycemia duration.

Conclusions:

  • VLBW infants demonstrate a hormonal profile suggestive of insulin resistance.
  • Factors like lower gestational age and hyperglycemia are significantly associated with elevated insulin resistance markers in VLBW infants.
Abstract

Keywords:
endocrinologyneonatology

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