title: Serum glucocorticoids and adiponectin associate with insulin resistance in children born small for gestational age.
abstract: OBJECTIVE
  Altered glucocorticoid activity is one possible mechanism linking fetal growth restriction with later insulin resistance (IR) and type 2 diabetes. We aimed to investigate whether serum glucocorticoid parameters are related to IR in children born small for gestational age (SGA).
  
  
  METHODS
  A total of 110 children (55 age- and gender-matched pairs born SGA or appropriate for gestational age (AGA) in a case-control setting) were studied at the mean age of 12.2 (s.d. 0.2) years.
  
  
  METHODS
  Serum cortisol, corticosteroid-binding globulin (CBG), free cortisol index (FCI=cortisol/CBG), and glucocorticoid bioactivity (GBA, transactivation assay) were analyzed and related to serum adiponectin and insulin-like growth factor-binding protein 1 (IGFBP1) concentrations and homeostasis model assessment for IR (HOMA-IR) and QUICKI indices.
  
  
  RESULTS
  In the pooled study population, GBA correlated well with cortisol and FCI (r=0.681 and 0.586 respectively; P<0.001 for both). Serum cortisol, CBG, FCI, GBA, HOMA-IR, or QUICKI did not differ between the SGA and AGA subjects, but the SGA children had lower body mass index (P=0.005) and waist circumference (WC) (P=0.001). The mean GBA in the highest GBA quartile was higher among the SGA subjects than among the AGA subjects (138.6 vs 96.4 nmol/l cortisol equivalents, P<0.001). In the SGA children, GBA correlated positively with HOMA-IR (r=0.522, P<0.001) and inversely with adiponectin (r=-0.278, P=0.042) (WC/height ratio adjustments), and in logistic regression analysis, higher GBA (odds ratio (OR) 1.3; P=0.013), lower adiponectin (OR 1.4; P=0.038), and lower IGFBP1 (OR 1.9; P=0.010) associated independently with higher HOMA-IR.
  
  
  CONCLUSIONS
  These findings suggest that increased glucocorticoid activity and low serum adiponectin concentrations associate with IR in SGA children.
authors.affiliation: Department of Pediatrics, University of Kuopio and Kuopio University Hospital, PO Box 1777, FI-70211 Kuopio, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Tenhola
authors.forename: B
authors.initials: B
authors.lastname: Todorova
authors.forename: J
authors.initials: J
authors.lastname: Jääskeläinen
authors.forename: O A
authors.initials: OA
authors.lastname: Jänne
authors.forename: T
authors.initials: T
authors.lastname: Raivio
authors.forename: R
authors.initials: R
authors.lastname: Voutilainen
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005938:Glucocorticoids / Q000097:blood*; D006801:Humans; D007124:Immunoenzyme Techniques; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D008297:Male; D018709:Statistics, Nonparametric
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D005938:Glucocorticoids; D007328:Insulin; D018970:Insulin-Like Growth Factor Binding Protein 1