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Reduced final height and indications for insulin resistance in 20 year olds born small for gestational age: regional
J Leger1, C Levy-Marchal, J Bloch
1Paediatric Endocrinology and Diabetes Unit, Hôpital Robert Debré, Paris, France.
Insights
Babies born small for gestational age are shorter and show early signs of insulin resistance by age 20. These findings suggest long-term health consequences of intrauterine growth restriction.
Area of Science:
- Endocrinology
- Developmental Biology
- Public Health
Background:
- Intrauterine growth restriction (IUGR) is linked to long-term metabolic and cardiovascular risks.
- The early-life origins of these health issues are not fully understood.
- Investigating health markers in young adulthood can provide insights into developmental impacts.
Purpose of the Study:
- To determine if the association between low birth weight and later health problems is evident by age 20.
- To assess metabolic and cardiovascular risk factors in young adults born small for gestational age (SGA).
Main Methods:
- A regional cohort study involving 236 individuals born SGA and 281 with normal birth weight.
- Participants were evaluated around age 20, assessing height, glucose tolerance, insulin, proinsulin, lipids, fibrinogen, and blood pressure.
Main Results:
- Individuals born SGA were significantly shorter at age 20 compared to controls.
- Higher plasma glucose, fasting insulin (in women), and insulin/proinsulin concentrations were observed in the SGA group post-glucose load.
- No significant differences were found in lipid, fibrinogen, or blood pressure levels between the groups.
Conclusions:
- Intrauterine growth retardation is associated with reduced final height.
- Elevated insulin and proinsulin concentrations in young adults born SGA may indicate early alterations in insulin sensitivity.
- These findings highlight potential long-term health consequences of being born small for gestational age.
Objective:
To investigate whether the association between low birth weight and increased risk of developing impaired glucose tolerance, insulin resistance, hypertriglyceridaemia, and hypertension in middle age is apparent by the age of 20 in people born small for gestational age.
Design:
Regional cohort study.
Setting:
Maternity registry, Haguenau, France.
Subjects:
236 full term singleton babies born small for gestational age (birth weight or length, or both, below third centile) during 1971-8 and 281 with normal birth weight (between 25th and 75th centile). All subjects were contacted and evaluated at a mean (SD) age of 20.6 (2.1) years.
Main Outcome Measures:
Adult height; concentrations of glucose, insulin, and proinsulin during an oral glucose tolerance test; lipid and fibrinogen concentrations; and blood pressure.
Results:
After sex and target height were adjusted for, subjects who had been born small for gestational age were significantly shorter at age 20 than those with a normal birth weight (men 4.5 cm shorter (95% confidence interval 6.0 to 3.0 cm); women 3.94 cm shorter (5.2 to 2.7 cm)). After sex and body mass index were adjusted for, mean plasma glucose concentration 30 minutes after a glucose load, fasting insulin concentration (in women), and insulin and proinsulin concentrations 30 and 120 minutes after a glucose load were significantly higher in subjects who had been born small for gestational age than in those with a normal birth weight. Mean lipid and fibrinogen concentrations and blood pressure were not different between the two groups.
Conclusions:
Intrauterine growth retardation has long term consequences such as reduced final height Raised insulin and proinsulin concentrations are present in young adults born small for gestational age and could be markers of early changes in insulin sensitivity.