Serum glucocorticoids and adiponectin associate with insulin resistance in children born small for gestational age.
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.
Tenhola
S
S
Department of Pediatrics, University of Kuopio and Kuopio University Hospital, PO Box 1777, FI-70211 Kuopio, Finland.
Todorova
B
B
Jääskeläinen
J
J
Jänne
O A
OA
Raivio
T
T
Voutilainen
R
R
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
D052242:Adiponectin; D001786:Blood Glucose; D005938:Glucocorticoids; D007328:Insulin; D018970:Insulin-Like Growth Factor Binding Protein 1