Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age

Kistner, Anna; Rakow, Alexander; Legnevall, Lena; Marchini, Giovanna; Brismar, Kerstin; Hall, Kerstin; Vanpée, Mireille

doi:10.1111/apa.12005

Cited by 18 publications

(29 citation statements)

References 35 publications

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“…In studies of individuals born SGA at term (defined as BW SDS below −2 SDS), signs of insulin resistance have been detected in children (5) and at young adulthood (6). In our group of children born SGA at term (defined as BW SDS below −2 SDS), we have recently found higher insulin levels compared with the controls when adjusted for BMI, indicating early signs of a peripheral insulin resistance (7).…”

Section: Introductionmentioning

confidence: 48%

“…The characterizations and the modes of selection for the children (7) and the adult women (23) were previously described in detail. In brief, of 257 children consequently born at the Karolinska University Hospital between the years 1990 and 1993 and invited to take part in a follow-up study, 105 excepted to participate and blood values were obtained in 76 subjects (7).…”

Section: Methodsmentioning

confidence: 99%

“…In brief, of 257 children consequently born at the Karolinska University Hospital between the years 1990 and 1993 and invited to take part in a follow-up study, 105 excepted to participate and blood values were obtained in 76 subjects (7). For women, a total of 77 female infants born preterm before gestational week 32 or born term SGA in the Stockholm area between the years 1967 and 1973 were contacted to take part in this study.…”

Section: Methodsmentioning

confidence: 99%

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Leptin may enhance hepatic insulin sensitivity in children and women born small for gestational age

Kistner

Vanpée

Hall

2013

Endocrine Connections

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ObjectiveChildren born small for gestational age (SGA) are at risk for developing type 2 diabetes. Lipodystrophy leads to early type 2 diabetes and leptin reverses the metabolic consequences of the disease. Low IGF-binding protein 1 (IGFBP1) can predict the development of type 2 diabetes. The aim of this study was to determine leptin, insulin, and IGFBP1 in children and adult women born preterm or SGA to evaluate the role of leptin as a compensatory mechanism in insulin resistance development.MethodsSeventy-six children (8.5–10 years, 41 girls and 35 boys) and 45 women (23–30 years) were studied. The children comprised subjects born appropriate for gestational age (<30 gestational weeks) (n=22), born SGA at term (n=23), and full-term normal-weight controls (n=31). Among the women, the corresponding figures were, n=10, n=18, and n=17 respectively. Fasting levels of IGFBP1, leptin, insulin, and IGF1 were determined and total adiponectin only in women.ResultsIn girls and women, term SGA subjects had higher leptin levels in relation to BMI SDS (P=0.042 and P=0.03 respectively). More than half of IGFBP1 variability was explained by leptin and insulin in children. In term SGA women, IGFBP1 level was lower compared with controls (P=0.012) and the regression line of IGFBP1 on insulin was suppressed below −1 s.d. of a reference material.ConclusionLeptin levels were elevated in term SGA girls and women, in particular in adult women, but not found in preterm girls and women. IGFBP1 was lower in term SGA women. In children, leptin and insulin were strong suppressors of IGFBP1. We speculate that higher leptin levels could be a protective event to enhance hepatic insulin sensitivity.

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Section: Introductionmentioning

confidence: 48%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Leptin may enhance hepatic insulin sensitivity in children and women born small for gestational age

Kistner

Vanpée

Hall

2013

Endocrine Connections

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“…In their study, the authors found that SGA infants had higher insulin levels and insulin resistance than their controls, suggesting peripheral insulin resistance. Also, the authors found that preterm infants had an attenuation in insulin-like growth factor-binding protein-1 (IGFBP-1) response during an oral glucose tolerance test (OGTT), suggesting a hepatic insulin resistance 33. Similarly, in a study of young adults born prematurely and SGA, Rotteveel et al43 found that preterm SGA adults have increased triglycerides and insulin during a mixed meal test.…”

Section: Metabolic Syndrome and Insulin Resistancementioning

confidence: 97%

“…In developing countries, the most common cause of asymmetrical IUGR remains caloric restriction or undernutrition. In developed countries, asymmetrical IUGR remains a problem in poverty stricken areas15 and it is associated with the hypertension spectrum,31,32 maternal diabetes, and vascular-related disorders such as lupus and smoking 33…”

Section: Iugr and Insulin Secretionmentioning

confidence: 99%

Prevalence of diabetes and obesity in association with prematurity and growth restriction

Kopec¹,

Shekhawat²,

Mhanna³

2017

DMSO

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Intrauterine growth restriction (IUGR) is when fetuses and newborn infants have not reached their true growth potential as genetically defined. Fetuses with IUGR develop in a less than ideal environment that leads to epigenetic changes and marks infants’ metabolism for the rest of their lives. Epigenetic changes affect insulin-like growth factor-1 (IGF-1) levels and lead to insulin resistance and ultimately to a metabolic syndrome. The metabolic syndrome is a constellation of illnesses that raise one’s risk for type 2 diabetes mellitus, coronary artery disease, and ischemic heart disease, including hypertension, dyslipidemia, central obesity, insulin resistance, and inflammation. The association between IUGR or prematurity and long-term insulin resistance, obesity, hypertension, and metabolic syndrome remains unclear. While studies have shown an association, others have not supported such association. If alteration of intrauterine growth can ultimately lead to the development of metabolic derangements in childhood and adulthood, and if such association is true, then early interventions targeting the health of pregnant women will ensure the health of the population to follow.

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Childhood Obesity and Insulin Resistance: How Should It Be Managed?

Garnett

Baur

2014

Curr Treat Options Cardio Med

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Concomitant with the rise in global pediatric obesity in the past decades, there has been a significant increase in the number of children and adolescents with clinical signs of insulin resistance. Given insulin resistance is the important link between obesity and the associated metabolic abnormalities and cardiovascular risk, clinicians should be aware of high risk groups and treatment options. As there is no universally accepted biochemical definition of insulin resistance in children and adolescents, identification and diagnosis of insulin resistance usually relies on clinical features such as acanthosis nigricans, polycystic ovary syndrome, hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Treatment for reducing insulin resistance and other obesity-associated comorbidities should focus on changes in health behaviors to achieve effective weight management. Lifestyle interventions incorporating dietary change, increased physical activity, and decreased sedentary behaviors, with the involvement of family and adoption of a developmentally appropriate approach, should be used as the first line treatment. Current evidence suggests that the primary objective of dietary interventions should be to reduce total energy intake and a combination of aerobic and resistance training should be encouraged. Metformin can be used in conjunction with a lifestyle intervention program in obese adolescents with clinical insulin resistance to achieve weight loss and to improve insulin sensitivity. Ongoing evaluation and research are required to explore optimal protocol and long-term effectiveness of lifestyle interventions, as well as to determine whether the improvements in insulin sensitivity induced by lifestyle interventions and weight loss will lead to a clinical benefit including reduced cardiovascular morbidity and mortality.

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Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age

Abstract: The higher fasting insulin level in the SGA children, adjusted for BMI, could indicate peripheral insulin resistance. Preterm born children had reduced suppression of IGFBP-1 during OGTT, suggesting hepatic insulin resistance.

Cited by 18 publications

References 35 publications

Leptin may enhance hepatic insulin sensitivity in children and women born small for gestational age

Leptin may enhance hepatic insulin sensitivity in children and women born small for gestational age

Prevalence of diabetes and obesity in association with prematurity and growth restriction

Childhood Obesity and Insulin Resistance: How Should It Be Managed?

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