Does gender-specific BMI development modulate insulin sensitivity in extremely low birth weight infants?
BACKGROUND
Increasing numbers of extremely low birth weight infants (ELBW, birth weight < 1,000 g) survive. We studied the impact of birth weight, gender, and catch-up growth on metabolic parameters in ELBW infants.
Sixty-three ELBW children were investigated at a mean age of 5.8 years. Forty-eight showed catch-up growth.


RESULTS
ELBW children who were small for gestational age were significantly shorter than those whose size was appropriate for their gestational age (height SDS: -1.1 [SD 0.8] vs -0.4 [0.9]; p < 0.001). This corresponded with significantly lower standard deviation scores for IGF-I (-1.1 [1.3] vs 0.1 [0.8]; p < 0.05) and IGFBP-3 (-0.7 [1.7] vs 0.4 [1.1]; p < 0.05). No differences were found regarding fasting insulin, glucose, HOMA and IGFBP-1. The catch-up group showed lower IGFBP-1 concentrations than the non-catch-up group. IGFBP-1 decreased in individuals who became more insulin resistant. No differences were found regarding mean IGF-1 and IGFBP-3 SDS. A gender-related pattern was found for weight development: girls demonstrated a normalization of BMI from the age of 2 years whereas boys remained at a mean BMI of -1.96 SDS. Corresponding to this, girls showed lower IGFBP-1 levels than boys.


CONCLUSIONS
Metabolic parameters in ELBW children are modulated by subsequent catch-up growth and sex-dependent weight development, resulting in measurable differences even in early childhood.
Gohlke
Bettina C
BC
Department of Pediatrics, University of Bonn, Bonn, Germany. bettina-gohlke@t-online.de
Stutte
Sonja
S
Bartmann
Peter
P
Woelfle
Joachim
J
D001724:Birth Weight / Q000502:physiology; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000097:blood / Q000254:growth & development / Q000378:metabolism*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood / Q000254:growth & development / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; 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; D012727:Sex Characteristics
C032231:IGFBP1 protein, human; C515497:IGFBP3 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I