ESPE Abstracts

Objective: To investigate whether the early-life overweight/obesity trajectory from ages 2, 4, to 8 affects insulin resistance (IR) in 8-year-old prepubertal children.

Methods: From the Environment and Development of Children (EDC) cohort, 262 prepubertal children (147 boys and 115 girls) who visited Seoul National University Children’s Hospital for anthropometric measurements at ages 2, 4 and 8 were included. At age 8, homeostatic model assessment of insulin resistance (HOMA-IR) was calculated as insulin (mIU/ml) × glucose (mg/dl)/405. Normal weight (NW, <85th BMI percentile), overweight (OW, 85–95th BMI percentile), and obese (OB, ≥95th BMI percentile) status from ages 2, 4, to 8 were accessed to define eight OWOB trajectory groups. The relationship of OWOB trajectory groups with glucose and HOMA-IR was analyzed after adjusting for age, sex, prematurity, small for gestational age, parental BMI, and parental education.

Results: NW groups at age 8 were classified into NW at ages 2, 4, and 8 (all-NW, n= 176), OWOB at age 2 and NW at ages 4 and 8 (OWOB-NW-NW, n= 13), NW-OWOB-NW (n= 9), and OWOB-OWOB-NW (n= 5). OWOB groups at age 8 were categorized into NW-NW-OWOB (n= 33), OWOB-NW-OWOB (n= 7), NW-OWOB-OWOB (n= 8), and OWOB at ages 2, 4, and 8 (all-OWOB, n= 11). For glucose levels, all-OWOB group only showed higher fasting glucose than the all-NW group (P= 0.015). For HOMA-IR, compared to all-NW group, OWOB at age 8 (all-OWOB, NW-OWOB-OWOB, OWOB-NWOWOB, and NW-NW-OWOB groups) or OWOB at age 4 (OWOB-OWOB-NW, and NW-OWOB-NW groups) showed higher HOMA-IR (all P<0.05). However, OWOB at age 2 but NW at age 4 and 8 (OWOB-NW-NW group) showed no difference in HOMA IR compared to all-NW group. Conclusion: Children who were OWOB at age 8 showed higher insulin resistance than NW children at ages 2, 4, and 8. Children who were OWOB at age 4 had higher insulin resistance than all NW children even if they were NW at age 8.