PEDIATRICS Vol. 111 No. 4 April 2003, pp. 804-809
Glucose and Lipid Metabolism in Small For Gestational Age Infants at 48 Hours of Age
* Institute for Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile
Neonatology Unit, Sótero del Río Hospital, Santiago, Chile
Neonatology Unit, San Borja-Arriarán Hospital, Santiago, Chile
|| Department of Paediatrics, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
--> Objective. To study the consequences of low birth weight on glucose and lipid metabolism 48 hours after delivery.
Methods. We studied 136 small for gestational age (SGA) and 34 appropriate for gestational age (AGA) term neonates who were born in Santiago, Chile. Prefeeding venous blood was obtained 48 hours after birth for determination of glucose, free fatty acids, ß-hydroxy butyrate, insulin, C-peptide, leptin, sex hormone-binding globulin, insulin-like growth factor-binding protein-1 (IGFBP-1), and cortisol.
Results. SGA newborns had lower glucose (SGA versus AGA, median [interquartile range]: 3.6 mmol/L [2.9–4.1 mmol/L] vs 3.9 mmol/L [3.6–4.6 mmol/L]) and insulin levels (31.3 pmol/L [20.8–47.9 pmol/L] vs 62.5 pmol/L [53.5–154.9]) than AGA infants, and they had higher glucose/insulin ratios (13.9 mg/dL/uIU/mL [8.6–19.1 mg/dL/uIU/mL] vs 8.2 mg/dL/uIU/mL [4.6–14.1 mg/dL/uIU/mL]). SGA infants also had higher levels of IGFBP-1 (5.1 nmol/L [4.4–6.7 nmol/L] vs 2.9 nmol/l [1.4–4.2 nmol/L]), free fatty acids (0.72 mEq/L [0.43–1.00 mEq/L] vs 0.33 mEq/L [0.26–0.54 mEq/L]) and ß-hydroxy butyrate (0.41 mEq/L [0.15–0.91 mEq/L] vs 0.09 mEq/L [0.05–0.13 mEq/L]). Sex-hormone binding globulin levels were not significantly different between the 2 groups.
Conclusions. In early postnatal life, SGA infants display an increased insulin sensitivity with respect to glucose disposal but not with respect to suppression of lipolysis, ketogenesis, and hepatic production of IGFBP-1. It will be important to determine how these differential sensitivities to insulin vary with increasing age.
Key Words: Barker hypothesis • low birth weight • insulin sensitivity
Abbreviations: LBW, low birth weight • SGA, small for gestational age • AGA, appropriate for gestational age • SHBG, sex hormone-binding globulin • IGFBP-1, insulin-like growth factor-binding protein-1 • FFA, free fatty acid • RIA, radioimmunoassay • CV, coefficient of variation • bOH-B, ß-hydroxy-butyrate • G/I, glucose/insulin • HOMA, homeostasis model assessment • GH, growth hormone
Received for publication May 28, 2002; Accepted Sep 19, 2002.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Beltrand, R. Verkauskiene, R. Nicolescu, O. Sibony, P. Gaucherand, D. Chevenne, O. Claris, and C. Levy-Marchal Adaptive Changes in Neonatal Hormonal and Metabolic Profiles Induced by Fetal Growth Restriction J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 4027 - 4032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Ibanez, G. Sebastiani, A. Lopez-Bermejo, M. Diaz, M. D. Gomez-Roig, and F. de Zegher Gender Specificity of Body Adiposity and Circulating Adiponectin, Visfatin, Insulin, and Insulin Growth Factor-I at Term Birth: Relation to Prenatal Growth J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2774 - 2778. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Movassat, D. Bailbe, C. Lubrano-Berthelier, F. Picarel-Blanchot, E. Bertin, J. Mourot, and B. Portha Follow-up of GK rats during prediabetes highlights increased insulin action and fat deposition despite low insulin secretion Am J Physiol Endocrinol Metab, January 1, 2008; 294(1): E168 - E175. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. S.E. Ahlsson, B. Diderholm, U. Ewald, and J. Gustafsson Lipolysis and Insulin Sensitivity at Birth in Infants Who Are Large for Gestational Age Pediatrics, November 1, 2007; 120(5): 958 - 965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Owens, K. L. Gatford, M. J. De Blasio, L. J. Edwards, I. C. McMillen, and A. L. Fowden Restriction of placental growth in sheep impairs insulin secretion but not sensitivity before birth J. Physiol., November 1, 2007; 584(3): 935 - 949. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Wallace, J. S. Milne, R. P. Aitken, and W. W. Hay Jr. Sensitivity to metabolic signals in late-gestation growth-restricted fetuses from rapidly growing adolescent sheep Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1233 - E1241. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Klamer, K Skogstrand, D M Hougaard, B Norgaard-Petersen, A Juul, and G Greisen Adiponectin levels measured in dried blood spot samples from neonates born small and appropriate for gestational age Eur. J. Endocrinol., August 1, 2007; 157(2): 189 - 194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Malamitsi-Puchner, D. D. Briana, M. Boutsikou, E. Kouskouni, D. Hassiakos, and D. Gourgiotis Perinatal Circulating Visfatin Levels in Intrauterine Growth Restriction Pediatrics, June 1, 2007; 119(6): e1314 - e1318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Rozance, S. W. Limesand, G. O. Zerbe, and W. W. Hay Jr. Chronic fetal hypoglycemia inhibits the later steps of stimulus-secretion coupling in pancreatic beta-cells Am J Physiol Endocrinol Metab, May 1, 2007; 292(5): E1256 - E1264. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. De Blasio, K. L. Gatford, I. C. McMillen, J. S. Robinson, and J. A. Owens Placental Restriction of Fetal Growth Increases Insulin Action, Growth, and Adiposity in the Young Lamb Endocrinology, March 1, 2007; 148(3): 1350 - 1358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. De Blasio, K. L. Gatford, J. S. Robinson, and J. A. Owens Placental restriction of fetal growth reduces size at birth and alters postnatal growth, feeding activity, and adiposity in the young lamb Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2007; 292(2): R875 - R886. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Thimmarayappa, J. Sun, L. E. Schultz, P. Dejkhamron, C. Lu, A. Giallongo, J. L. Merchant, and R. K. Menon Inhibition of Growth Hormone Receptor Gene Expression by Saturated Fatty Acids: Role of Kruppel-Like Zinc Finger Factor, ZBP-89 Mol. Endocrinol., November 1, 2006; 20(11): 2747 - 2760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Rozance, S. W. Limesand, and W. W. Hay Jr. Decreased nutrient-stimulated insulin secretion in chronically hypoglycemic late-gestation fetal sheep is due to an intrinsic islet defect Am J Physiol Endocrinol Metab, August 1, 2006; 291(2): E404 - E411. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Garg, M. Thamotharan, L. Rogers, S. Bassilian, W. N. P. Lee, and S. U. Devaskar Glucose metabolic adaptations in the intrauterine growth-restricted adult female rat offspring Am J Physiol Endocrinol Metab, June 1, 2006; 290(6): E1218 - E1226. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Stefan, H. Ji, R. A. Simmons, D. E. Cummings, R. S. Ahima, M. I. Friedman, and R. D. Nicholls Hormonal and Metabolic Defects in a Prader-Willi Syndrome Mouse Model with Neonatal Failure to Thrive Endocrinology, October 1, 2005; 146(10): 4377 - 4385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Codner, D. Mook-Kanamori, R. A. Bazaes, N. Unanue, H. Sovino, F. Ugarte, A. Avila, G. Iniguez, and F. Cassorla Ovarian Function during Puberty in Girls with Type 1 Diabetes Mellitus: Response to Leuprolide J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3939 - 3945. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. C. Mcmillen and J. S. Robinson Developmental Origins of the Metabolic Syndrome: Prediction, Plasticity, and Programming Physiol Rev, April 1, 2005; 85(2): 571 - 633. [Abstract] [Full Text] [PDF]
|
|
