ESPE Abstracts (2018) 89 P-P1-067

Insulin Resistance Parameters in Children Who Were Born Very Preterm and Adequate for Gestational Age

Hernán Garcíaa, Helena Poggia, Mónica Arancibiab,c, Soledad Peredod, Claudia Trincadoe, Rosario Mooree, Ivonne D’Apremonte,f, Daniela Andradeg, Sofía Sifaquia, JT Ossaa, Carmen Campinoh, Cristian Carvajalh, Carlos Fardellah, René Baudrandh, Sandra Solarii, Fidel Allendei & Alejandro Martínez-Aguayoa


aEndocrinology Unit, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; bEndocrinology Unit, Division of Pediatrics, Faculty of Medicine, Pontifica Universidad Católica de Chile, Santiago, Chile; cServicio de Pediatría, Hospital Higueras, Talcahuano, Chile; dNephrology Unit, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; eDivision of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; eComplejo Asistencial Sótero del Río, Santiago, Chile; fRed de Salud UC-Christus, Santiago, Chile; gEndocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; hDepartment of Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.


Background: Very preterm neonates are at risk for metabolic syndrome later in life. Our objective was to compare anthropometric measures and insulin resistance variables between children who were born very preterm (VPT, <32 gestational weeks) and term (T, >37 gestational weeks), and adequate for gestational age (AGA).

Methods: In this cross-sectional cohort study we recruited 113 children 5.0 to 8.5 years old from the preterm clinic of our institutions: 72 VPT (gestational age =29±2 weeks) and 41 T (gestational age 39±1 weeks) with a similar socio-economical background. All children presented a Birth Weight Standard Deviation Score (BW-SDS) higher than 2, as calculated using INTERGROWTH21. We measured height, weight and abdominal circumference, and calculated body mass index (BMI) percentiles using WHO references. After overnight fasting, glycemia, insulin, triglycerides and HDL-Cholesterol were determined. We determined the homeostasis model assessment insulin resistance (HOMA-IR) index, the quantitative insulin-sensitivity check index (QUICKI), and the triglyceride to HDL-C ratio (TG/HDL-C).

Results: VPT and T were comparable in chronological age (6.6±0.9 vs. 6.7±1.0 years; P=0.535) and anthropometrics variables: height-S.D.S. (−0.19±0.86 vs. 0.10±1.03; P=0.903), abdominal circumferences (58.5±7.4 vs. 58.50±7.1 cm; P=0.982), BMI-percentile (59.0±32.0 vs. 64.0±29.0th; P=0.476), and BW-SDS (0.40±1.03 vs. 0.52±0.72; P=0.512). Insulin-resistance parameters are presented in the Table 1. As expected there is a positive correlation BMI and TG/HDL-C ratio (r=0.281; P=0.003).

Table 1
VPT (n=72)T (n=41) TOTAL (n=113)P value
Glycemia (mg/dl)84.54±6.5283.10±7.1984.02±6.77 0.278
Insulin (uU/ml)5.79±3.395.36±2.565.63±3.110.485
HOMA-IR 1.23±0.751.12±0.561.19±0.69 0.425
QUICKI0.17±0.020.17±0.04 0.17±0.03 0.269
TG/HDL-C1.44±1.03 1.01±0.46 1.28±0.890.014

Conclusion: At this age, insulin-resistance parameters in children who were born very preterm and adequate for gestational age were not different compared to children born at term. Nevertheless, TG/HDL-C ratios were higher in VPT which could suggest a potential metabolic risk; therefore, it is essential to follow this group during their lifespan. Fondecyt 1160836