Glucose regulation in young adults with very low birth weight.
BACKGROUND
The association between small size at birth and impaired glucose regulation later in life is well established in persons born at term. Preterm birth with very low birth weight (<1500 g) is also associated with insulin resistance in childhood. If insulin resistance persists into adulthood, preterm birth with very low birth weight also may be associated with an increased risk of disease in adulthood. We assessed glucose tolerance and insulin sensitivity and measured serum lipid levels and blood pressure in young adults with very low birth weight.


METHODS
We performed a standard 75-g oral glucose-tolerance test, measuring insulin and glucose concentrations at baseline and at 120 minutes in 163 young adults (age range, 18 to 27 years) with very low birth weight and in 169 subjects who had been born at term and were not small for gestational age. The two groups were similar with regard to age, sex, and birth hospital. We measured blood pressure and serum lipid levels, and in 150 very-low-birth-weight subjects and 136 subjects born at term, we also measured body composition by means of dual-energy x-ray absorptiometry.


RESULTS
As compared with the subjects born at term, the very-low-birth-weight subjects had a 6.7% increase in the 2-hour glucose concentration (95% confidence interval [CI], 0.8 to 12.9), a 16.7% increase in the fasting insulin concentration (95% CI, 4.6 to 30.2), a 40.0% increase in the 2-hour insulin concentration (95% CI, 17.5 to 66.8), an 18.9% increase in the insulin-resistance index determined by homeostatic model assessment (95% CI, 5.7 to 33.7), and an increase of 4.8 mm Hg in systolic blood pressure (95% CI, 2.1 to 7.4). Adjustment for the lower lean body mass in the very-low-birth-weight subjects did not attenuate these relationships.


CONCLUSIONS
Young adults with a very low birth weight have higher indexes of insulin resistance and glucose intolerance and higher blood pressure than those born at term.
Hovi
Petteri
P
Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland. petteri.hovi@helsinki.fi
Andersson
Sture
S
Eriksson
Johan G
JG
Järvenpää
Anna-Liisa
AL
Strang-Karlsson
Sonja
S
Mäkitie
Outi
O
Kajantie
Eero
E
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D044882:Glucose Metabolism Disorders / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007328:Insulin / Q000378:metabolism*; D008055:Lipids / Q000097:blood; D008297:Male
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids