title: Insulin resistance and body composition in preterm born children during prepubertal ages.
abstract: BACKGROUND
  Premature born children may show insulin resistance in childhood which may be due to intrauterine or postnatal adverse environmental factors.
  
  
  OBJECTIVE
  Aim of this study was to evaluate insulin resistance and body composition in preterm born children born appropriate for gestational age (AGA) or small for gestational age (SGA) and relations with IGF-I, IGFBP-3 axis.
  
  
  METHODS
  Ninety-three preterm born children grouped as premature SGA (n = 30) and premature AGA (n = 63) were evaluated at age 4.6 +/- 0.2 years and 4.7 +/- 0.1 years with respect to their glucose, insulin, IGF-I, IGFBP-3, IGFBP-1, leptin levels and body composition by dual-energy X-ray absorptiometry. Their data were compared to that of body mass index (BMI) matched term SGA (n = 42) and term AGA (n = 44) children of age 4.5 +/- 0.2 and 3.8 +/- 0.1 years. All children had height appropriate for their target height. Insulin resistance was evaluated by basal insulin and homeostasis model assessment for insulin resistance (HOMA-IR).
  
  
  RESULTS
  Basal insulin level was similar in preterm AGA (4.3 +/- 1.4 pmol/l) and term AGA (7.9 +/- 6.4 pmol/l) children at similar and normal BMI levels. Preterm SGA children had insulin levels (5.0 +/- 3.6 pmol/l) similar to preterm AGA children but significantly lower than that in term SGA children (23.7 +/- 20.8 pmol/l) (P = 0.001). Similar results were obtained for HOMA-IR. Term SGA children had also significantly lower IGFBP-1 levels. Body composition, leptin and IGFBP-3 did not differ between the respective groups. IGF-I was lower in preterm AGA (5.0 +/- 0.6 nmol/l) than in term AGA (8.3 +/- 1.2 nmol/l) (P < 0.001) children.
  
  
  CONCLUSIONS
  Premature born AGA and SGA children do not have insulin resistance when compared to term children if they have made a catch-up growth appropriate for their target height and have normal BMI. The similar insulin levels in preterm SGA and preterm AGA children together with increased insulin levels in term SGA children points to the fact that it is the intrauterine restriction in the third trimester that has an adverse effect on future adverse metabolic outcome.
authors.affiliation: Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. feyzad@istanbul.edu.tr
authors.forename: Feyza
authors.initials: F
authors.lastname: Darendeliler
authors.forename: Firdevs
authors.initials: F
authors.lastname: Bas
authors.forename: Ruveyde
authors.initials: R
authors.lastname: Bundak
authors.forename: Asuman
authors.initials: A
authors.lastname: Coban
authors.forename: Ozlem
authors.initials: O
authors.lastname: Sancakli
authors.forename: Sema Kabatas
authors.initials: SK
authors.lastname: Eryilmaz
authors.forename: Banu
authors.initials: B
authors.lastname: Kucukemre
authors.forename: Rian
authors.initials: R
authors.lastname: Disci
authors.forename: Gulbin
authors.initials: G
authors.lastname: Gokcay
authors.forename: Semih
authors.initials: S
authors.lastname: Aki
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Ince
authors.forename: Nurten
authors.initials: N
authors.lastname: Eskiyurt
mesh_terms: D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D047928:Premature Birth; D011627:Puberty / Q000502:physiology*
chemical_list: C515497:IGFBP3 protein, human; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I