AIMS/HYPOTHESIS: Insulin resistance and type 2 diabetes risk in human subjects who were small-for-gestational-age (SGA) at birth may be a consequence of rapid early postnatal weight gain. MATERIALS AND METHODS: We prospectively studied early changes in fasting insulin sensitivity and insulin secretion, assessed by a short intravenous glucose tolerance test that was conducted several times from birth to 3 years of age in 55 SGA (birthweight below fifth percentile) newborns and in 13 newborns with a birthweight appropriate for gestational age (AGA). RESULTS: Most SGA infants showed postnatal upward weight centile crossing and by 3 years were similar in size to AGA infants. SGA infants had lower pre-feed insulin levels at postnatal age 48 h than AGA infants (median 34.4 vs 59.7 pmol/l, p<0.05), but by the age of 3 years they had higher fasting insulin levels (median 38.9 vs 23.8 pmol/l, p<0.005), which were related to rate of weight gain between 0 and 3 years (r=0.47, p=0.0003). First-phase insulin secretion did not differ between SGA and AGA infants, but SGA infants had a lower glucose disposition index (beta cell compensation) (median 235 vs 501 min mmol(-1) l(-1), p=0.02), which persisted after allowing for postnatal weight gain (p=0.009). CONCLUSIONS/ INTERPRETATION: SGA infants showed a marked transition from lower pre-feed insulin and increased insulin sensitivity at birth to insulin resistance over the first 3 years of life. This transition was related to rapid postnatal weight gain, which could indicate a propensity to central fat deposition. The additional observation of reduced compensatory beta cell secretion underlines the need for long-term surveillance of glucose homeostasis in all SGA subjects, whether or not they show postnatal catch-up growth.
AIMS/HYPOTHESIS: Insulin resistance and type 2 diabetes risk in human subjects who were small-for-gestational-age (SGA) at birth may be a consequence of rapid early postnatal weight gain. MATERIALS AND METHODS: We prospectively studied early changes in fasting insulin sensitivity and insulin secretion, assessed by a short intravenous glucose tolerance test that was conducted several times from birth to 3 years of age in 55 SGA (birthweight below fifth percentile) newborns and in 13 newborns with a birthweight appropriate for gestational age (AGA). RESULTS: Most SGA infants showed postnatal upward weight centile crossing and by 3 years were similar in size to AGA infants. SGA infants had lower pre-feed insulin levels at postnatal age 48 h than AGA infants (median 34.4 vs 59.7 pmol/l, p<0.05), but by the age of 3 years they had higher fasting insulin levels (median 38.9 vs 23.8 pmol/l, p<0.005), which were related to rate of weight gain between 0 and 3 years (r=0.47, p=0.0003). First-phase insulin secretion did not differ between SGA and AGA infants, but SGA infants had a lower glucose disposition index (beta cell compensation) (median 235 vs 501 min mmol(-1) l(-1), p=0.02), which persisted after allowing for postnatal weight gain (p=0.009). CONCLUSIONS/ INTERPRETATION: SGA infants showed a marked transition from lower pre-feed insulin and increased insulin sensitivity at birth to insulin resistance over the first 3 years of life. This transition was related to rapid postnatal weight gain, which could indicate a propensity to central fat deposition. The additional observation of reduced compensatory beta cell secretion underlines the need for long-term surveillance of glucose homeostasis in all SGA subjects, whether or not they show postnatal catch-up growth.
Authors: K K Ong; C J Petry; P M Emmett; M S Sandhu; W Kiess; C N Hales; A R Ness; D B Dunger Journal: Diabetologia Date: 2004-05-20 Impact factor: 10.122
Authors: Hong Liu; Christopher G Schultz; Miles J De Blasio; Anita M Peura; Gary K Heinemann; Himawan Harryanto; Damien S Hunter; Amy L Wooldridge; Karen L Kind; Lynne C Giles; Rebecca A Simmons; Julie A Owens; Kathryn L Gatford Journal: Am J Physiol Endocrinol Metab Date: 2015-07-28 Impact factor: 4.310
Authors: Dustin T Yates; Jessica L Petersen; Ty B Schmidt; Caitlin N Cadaret; Taylor L Barnes; Robert J Posont; Kristin A Beede Journal: J Anim Sci Date: 2018-06-29 Impact factor: 3.159
Authors: Dustin T Yates; Caitlin N Cadaret; Kristin A Beede; Hannah E Riley; Antoni R Macko; Miranda J Anderson; Leticia E Camacho; Sean W Limesand Journal: Am J Physiol Regul Integr Comp Physiol Date: 2016-04-06 Impact factor: 3.619
Authors: Julie A Owens; Kathryn L Gatford; Miles J De Blasio; Lisa J Edwards; I Caroline McMillen; Abigail L Fowden Journal: J Physiol Date: 2007-08-30 Impact factor: 5.182
Authors: Roy Joseph; Jeremie Poschmann; Rami Sukarieh; Peh Gek Too; Sofi G Julien; Feng Xu; Ai Ling Teh; Joanna D Holbrook; Kai Lyn Ng; Yap Seng Chong; Peter D Gluckman; Shyam Prabhakar; Walter Stünkel Journal: Mol Endocrinol Date: 2015-04-27