A cross-sectional study of glucose regulation in young adults with very low birth weight: impact of male gender on hyperglycaemia.
OBJECTIVE
To investigate glucose regulation in young adults with very low birth weight (VLBW; <1500 g) in an Asian population.


METHODS
Cross-sectional observational study.


METHODS
A general hospital in Hamamatsu, Japan.


METHODS
111 young adults (42 men and 69 women; aged 19-30 years) born with VLBW between 1980 and 1990. Participants underwent standard 75 g oral glucose tolerance test (OGTT).


METHODS
The primary outcomes were glucose and insulin levels during OGTT and risk factors for a category of hyperglycaemia defined as follows: diabetes mellitus, impaired glucose tolerance (IGT), impaired fasting glycaemia (IFG) and non-diabetes/IGT/IFG with elevated 1 h glucose levels (>8.6 mmol/l). The secondary outcomes were the pancreatic β cell function (insulinogenic index and homeostasis model of assessment for beta cell (HOMA-β)) and insulin resistance (homeostasis model of assessment for insulin resistance (HOMA-IR)).


RESULTS
Of 111 young adults with VLBW, 21 subjects (19%) had hyperglycaemia: one had type 2 diabetes, six had IGT, one had IFG and 13 had non-diabetes/IGT/IFG with elevated 1 h glucose levels. In logistic regression analysis, male gender was an independent risk factor associated with hyperglycaemia (OR 3.34, 95% CI 1.08 to 10.3, p=0.036). Male subjects had significantly higher levels of glucose and lower levels of insulin during OGTT than female subjects (p<0.001 for glucose and p=0.005 for insulin by repeated measures analysis of variance). Pancreatic β cell function was lower in men (insulinogenic index: p=0.002; HOMA-β: p=0.001), although no gender difference was found in insulin resistance (HOMA-IR: p=0.477). In male subjects, logistic regression analysis showed that small for gestational age was an independent risk factor associated with hyperglycaemia (OR 33.3, 95% CI 1.67 to 662.6, p=0.022).


CONCLUSIONS
19% of individuals with VLBW already had hyperglycaemia in young adulthood, and male gender was a significant independent risk factor of hyperglycaemia. In male young adults with VLBW, small for gestational age was associated with hyperglycaemia.
Department of Endocrinology and Metabolism, Division of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Ryosuke
R
Sato
Hiroshi
H
Watanabe
Kenji
K
Shirai
Shigeru
S
Ohki
Rieko
R
Genma
Hiroshi
H
Morita
Eisuke
E
Inoue
Masahiro
M
Takeuchi
Masato
M
Maekawa
Hirotoshi
H
Nakamura