ESPE Abstracts (2014) 82 P-D-2-2-462

Adiponectin Levels as Early Marker of Insulin Resistance in Children Born Small for Gestational Age in Our Cohort

Sangita Yadav, Ainam Gupta, Siddharth Ramji & T K Mishra

Department of Pediatrics and Biochemistry, Maulana Azad Medical University of Delhi, New Delhi, India

Background: Small for gestational age (SGA) children, especially those with postnatal catchup growth, have increased risk of insulin resistance and adult metabolic diseases. Adipokines produced by adipose tissue play crucial role in fetal growth and early postnatal life. Low adiponectin (adipokine) is marker of insulin resistance.

Objective: To evaluate adiponectin levels in term SGA at 15–18 months age and its relationship with postnatal catchup growth (CUG).

Methods: Sixty term SGA children (birth weight<10th percentile) were enrolled at 15–18 months age. Birth weight and length recorded from discharge document and current weight and length measured at inclusion. Data analyzed for CUG as gain in weight or length SDS or both >0.67 (percentile band). Adiponectin levels were measured using ELISA Kit.

Results: Average birth weight, length, and gestational age was 2.08±0.2 kg (−2.9±0.6 S.D.), 45.1±2.5 cm (−2.4±1.4 S.D.), 38.4±1.2 weeks respectively. At enrolment mean age, weight, and length was 16.9±1.2 months, 8.2±0.8 kg (−2±0.9 S.D.), 73.0±3.0 cm (−2.3±1.1 S.D.). 65% (39) out of 60 SGA infants showed CUG and 21 did not have catchup growth (NCUG). Adiponectin levels in the cohort were 8.6±4.0 μg/ml and were similar in CUG (8.7±4.36 μg/ml) and NCUG (8.5±3.41 μg/ml).

Conclusion: 65% infants born SGA showed CUG by 18 months. The study cohort had lower mean adiponectin levels when compared with western studies; 21.6±0.6 μg/ml at 1 year and 15.7±0.4 μg/ml at 2 years (Iniguez et al) and 35.51±8.76 μg/ml at 1 year (Bozzola et al.). Thus lower adiponectin levels might suggest that our SGA cohort is more prone to develop adiposity and insulin resistance. This further reinforces inherent suspectibility of Indian population to develop adult metabolic syndrome. May also reflect ethnic variations of mean adiponectin levels as there are no normograms available for our Indian population. This warrants further research.

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