Insulin Sensitivity and Secretion Are Related to Catch-Up Growth in Small-for-Gestational-Age Infants at Age 1 Year: Results from a Prospective Cohort

Abstract

Strong associations between low birth weight and insulin resistance have been described. However, most of these studies have been retrospective. We aimed to determine whether infants born small for gestational age (SGA: birth weight <5th percentile for gestational age) have decreased insulin sensitivity, compared with appropriate for gestational age (AGA: birth weight >10th percentile) at 1 yr of age. We studied blood lipids, fasting insulin levels, other markers of insulin sensitivity, and insulin secretion during an iv glucose tolerance test in a cohort of 85 SGA and 23 AGA 1-yr-old infants. In addition, SGA infants were stratified according to catch-up growth (CUG) in weight (WCUG) or length (LCUG) during the first year of life. At 1 yr, SGA infants had a clear tendency to higher triglycerides. Fasting insulin was significantly higher in SGA infants with WCUG, compared with those who did not catch up and AGA infants (mean +/- SEM, 32.6 +/- 4.6 vs. 14.9 +/- 2.3 vs. 21.4 +/- 3.3 pM, respectively; P < 0.05). Length increment (in SD score) was the principal determinant of postload insulin secretion (R(2) = 0.1, P < 0.01). We conclude that insulin secretion and sensitivity are closely linked to patterns of rapid WCUG and LCUG during early postnatal life. Fasting insulin sensitivity is more related to WCUG and current body mass index, whereas insulin secretion seems to be directly related to LCUG.

Systematic review indicates postnatal growth in term infants born small‐for‐gestational‐age being associated with later neurocognitive and metabolic outcomes

“…Only one study comprising 165 children reported that faster weight gain between birth to eight years was positively associated with higher total cholesterol and triglycerides at the age of eight years 44. In contrast, a further five studies comprising 364 children reported no association between postnatal growth between the ages of zero and one to eight years and lipid levels in terms of total cholesterol, low‐density lipoprotein, high‐density lipoprotein or triglycerides at the ages of one to eight years 15, 17, 31, 37, 45. Furthermore, three studies comprising 189 children reported that faster height or length gain between birth and five to eight years was negatively associated with total cholesterol, low‐density lipoprotein and high‐density lipoprotein 17, 31, 50.…”

Preterm birth and later insulin resistance: effects of birth weight and postnatal growth in a population based longitudinal study from birth into adult life

“…To date, a number of studies have investigated the effect of infancy weight gain on later type 2 diabetes [3,11,35,36]. In middle-aged subjects, low weight at birth and at age 1 year were associated with type 2 diabetes, but the rate of weight gain in the first year of life was unrelated to type 2 diabetes [35].…”

“…Low birthweight after full-term gestation is associated with insulin resistance, glucose intolerance and type 2 diabetes in later life [1,2]. The effect of low birthweight on increased type 2 diabetes risk is stronger in subjects who catch up in weight during infancy, and in those who become overweight during childhood and in adult life [3][4][5]. Also, low weight in infancy has been associated with type 2 diabetes [1,6].…”

Adult BMI and fat distribution but not height amplify the effect of low birthweight on insulin resistance and increased blood pressure in 20-year-old South Africans

“…These observations, made in the absence of centralisation of body fat stores or frank obesity in the low-birthweight group, are of interest, as recently consideration has been given to the potential interaction between low birthweight and subsequent growth or the presence of obesity in the development of these adultonset chronic diseases [4,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]. A number of studies have reported that features of the chronic disease phenotype have been accentuated or amplified in the presence of postnatal or childhood skeletal catch-up growth [17,19,22,24], although this has not been a universal finding. A positive association between skeletal catch-up growth and systolic BP was reported in all three studies in which this was examined in children, adolescents and adults [6].…”