Background: Subjects born small for gestational age (SGA) were shown to be at higher risk to later metabolic consequences but early prediction factors of changes in glucose metabolism are not clearly known.
Objective and hypotheses: We aimed to investigate glucose tolerance and insulin resistance in adolescents born SGA or appropriate for gestational age (AGA) and their relationship with perinatal and postnatal factors.
Method: A prospective cohort of 48 SGA and 98 AGA children was followed-up from birth to adolescence (75 boys, 71 girls). At the time of study subjects were 1115 years old (mean 13.1±1.4; SGA 12.3±1.1; AGA 13.5±1.4 years). 14.6% of SGA children did not show catch-up growth. Statistical analyses were adjusted for sex, age, pubertal stage and BMI SDS.
Results: SGA children without catch-up had higher glucose concentration 30 min. after glucose load than those with catch-up growth or AGA (9.03±0.61 vs 7.38±0.23 (P=0.01); 7.2±0.15 mmol/l (P=0.005), respectively). In both SGA groups 120 min. postload glycemia was higher than in AGA, but the difference was more pronounced between AGA and SGA without catch-up growth (AGA 5.81±1.13; SGA with catch-up growth 6.37±1.07 (P=0.04); SGA without catch-up growth 7.43±2.01 mmol/l (P=0.01)). The differences in insulin levels and HOMA-IR were not significant between groups. Higher 120 min. glucose concentration was related with lower birth weight and length (r=−0.222, P=0.008; r=−0.169, P=0.046), birth weight and length SDS (r=−0.283, P=0.001; r=−0.215, P=0.011), birth BMI (r=−0.199, P=0.018) and faster prepubertal BMI growth rate (r=0.267, P=0.012). Fasting insulin and HOMA-IR correlated directly with height growth velocity during first month after birth (r=0.252, P=0.018; r=0.237, P=0.027), height and weight gain during first 6 years of life (r=0.419, P=0.021; r=0.408, P=0.025).
Conclusion: Small size at birth, higher prepubertal BMI gain and absence of postnatal catch-up growth are related to higher posprandial glucose levels at puberty.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology