SGA children with moderate catch-up growth are showing the impaired insulin secretion at the age of 4

PLoS One. 2014 Jun 30;9(6):e100337. doi: 10.1371/journal.pone.0100337. eCollection 2014.

Abstract

Background: Being born small for gestational age (SGA) is a risk factor for later development of type 2 diabetes. The development of glucose tolerance disorders in adults involves insulin resistance and impaired insulin secretion.

Objective: To evaluate insulin secretion and insulin sensitivity in a 4-yr old cohort of SGA.

Methods: 85 children were prospectively followed from mid-gestation to 4 years of age. Fetal growth velocity (FGV) was measured using ultrasound measurements. Body composition and hormonal profile were measured at birth, 1 and 4 years.

Results: 23 SGA babies had lower birth weight compared to 62 AGA (-1.9±0.3 vs. -0.6±0.8 z-score; p<0.0001) and they were thinner at birth (ponderal index 24.8±1.8 vs. 26.3±3.1 kg/m3; p = 0.01 and fat mass 11±2.6 vs. 12.9±3.1%; p = 0.01). No significant differences in other measured metabolic and hormonal parameters were observed between two groups at birth. SGA infants experienced an early catch-up growth in weight (mean gain of 1.1±0.6 SD) during the first year of life. At 4 years, SGA children remain lighter than AGA, but with weight z-score in the normal range (-0.1±1.3 vs. 0.5±1.3 z-score; p = 0.05). No excess of fat mass was observed (19±4.8 vs. 19.7±4.1%; p = 0.45). 120-min plasma glucose was significantly higher (6.2±1.1 vs. 5.6±0.9 mmol/l; p = 0.006) and insulinogenic index was significantly lower (0.28±0.15 vs. 0.40±2.4; p = 0.02) in the SGA group at 4-yrs of life contrasting with a preserved insulin sensitivity (QUICKI 0.47±0.09 vs. 0.43±0.05; p = 0.06).

Conclusion: SGA children with compensatory catch-up growth in first year of life show mild disturbances of glucose tolerance associated to a lower insulinogenic index at 4-yrs of age suggesting impairment of β-cell function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Body Height
  • Body Mass Index
  • Body Weight
  • Child, Preschool
  • Female
  • Glucose Tolerance Test
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infant, Small for Gestational Age*
  • Insulin / blood
  • Insulin / metabolism*
  • Insulin Resistance*
  • Insulin Secretion
  • Insulin-Secreting Cells / metabolism*
  • Insulin-Secreting Cells / pathology
  • Longitudinal Studies
  • Male

Substances

  • Blood Glucose
  • Insulin

Grant support

This work was supported by a grant from the “Institut National de la Santé et de la Recherche Médicale (INSERM)”, a grant from the «Programme Hospitalier de Recherche Clinique» (AOM 06-136, 2006) and from Pfizer Inc. Jacques Beltrand was supported by a fellowship from the “Institut Appert” (France, 2006) and by INSERM (Poste d'accueil, 2007). Ivana Milovanovic was supported by a fellowship SFP 2011. Falucar Njuieyon was supported by a fellowship SFEDP 2009. Claire Levy-Marchal was awarded a Contrat d'Interface de Recherche Hospitalière 2007–2012 from Assistance Publique-Hôpitaux de Paris. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.