ESPE2015 Poster Category 3 Hypo (26 abstracts)
Auxological Characteristics of Persistent Hyperinsulinemic Hypoglycemia at Birth
Hironori Shibata a , Mamiko Yamada a , Tomohiro Ishii a , Yohei Matsuzaki a , Kazushige Ikeda a , Yuka Nagashima b , Masaki Takagi b , Yukihiro Hasegawa b & Tomonobu Hasegawa a
aDepartment of Pediatrics, Keio University School of Medicine, Tokyo, Japan; bDepartment of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
Background: Most infants with persistent hyperinsulinaemic hypoglycaemia (PHH) are born large for gestational age (LGA) due to excessive anabolic effect of prenatal hyperinsulinism. However, other auxological characteristics than weight in infants with PHH have not been described well.
Objective: The objective of this investigation was to characterize anthropometric parameters at birth (weight, length, and head circumference) in PHH compared with those in idiopathic LGA.
Method: Clinical data in full term birth for PHH and idiopathic LGA were retrospectively collected at two institutions. We excluded infants of diabetic mothers or those with known overgrowth syndrome. Variables analysed included birth weight SDS, length SDS, and head circumference SDS. The variables between PHH and idiopathic LGA were compared using the Mann–Whitney U test.
Results: The present study included seven infants with PHH and 134 with idiopathic LGA. The birth weight SDS in PHH (median, 3.03; range, 1.46 to 3.67) were significantly greater than that in idiopathic LGA (1.75; 1.04 to 4.03) (P=0.01). The birth length SDS in PHH (1.45; 0.25 to 2.73) were significantly greater than that in idiopathic LGA (0.90, −2.19 to 3.19) (P=0.02). There was no significant difference in head circumference SDS between PHH (0.71; 0.19 to 1.70) and idiopathic LGA (1.14; −1.52 to 3.34). The difference between birth weight and head circumference SDS in PHH (median, 1.94; range, 0.33 to 3.14) were significantly greater than that in idiopathic LGA (0.64; −1.66 to 3.13) (P=0.003). The difference between birth length and head circumference SDS in PHH (median, 0.73; range, −0.06 to 1.83) were significantly greater than that in idiopathic LGA (−0.19; −2.61 to 2.04) (P=0.01).
Conclusion: These data indicate excessive prenatal growth in weight and length for infants with PHH, but not in head circumference. Prenatal growth promoting effect of insulin may differ depending on body and brain.
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