title: Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age.
abstract: OBJECTIVE
  To evaluate the impact of prenatal or postnatal compromised environment on glucose homoeostasis in children born preterm and appropriate for gestational age or small for gestational age (SGA) at term.
  
  
  METHODS
  Seventy-seven children (median 9.9 years, range 8.5-10) born at Karolinska Hospital were allocated to three groups: 21 subjects born before 30 weeks of gestational age (preterm), 26 SGA at term and 30 at term with appropriate birth weight (control). Anthropometric measurements were taken, and fasting blood samples for haemoglobin A1c, glucose, insulin, IGFBP-1, IGF-1 and lipid profile were taken. Glucose, insulin and IGFBP-1 samples were taken at 0, 30 and 120 min during an oral glucose tolerance test (OGTT).
  
  
  RESULTS
  Subjects born preterm or SGA were shorter and thinner compared with Controls. After adjustment for body mass index (BMI), the SGA group had higher basal insulin levels (p = 0.029), higher homoeostasis model assessment-insulin resistance (p = 0.012) and lower whole-body insulin sensitivity index (p = 0.007) than Controls. IGFBP-1 decrease during OGTT was attenuated in the Preterm group compared with the Control (p = 0.045) and SGA groups (p = 0.007).
  
  
  CONCLUSIONS
  The higher fasting insulin level in the SGA children, adjusted for BMI, could indicate peripheral insulin resistance. Preterm born children had reduced suppression of IGFBP-1 during OGTT, suggesting hepatic insulin resistance.
authors.affiliation: Department of Molecular Medicine and Surgery, Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. anna.kistner@ki.se
authors.forename: Anna
authors.initials: A
authors.lastname: Kistner
authors.forename: Alexander
authors.initials: A
authors.lastname: Rakow
authors.forename: Lena
authors.initials: L
authors.lastname: Legnevall
authors.forename: Giovanna
authors.initials: G
authors.lastname: Marchini
authors.forename: Kerstin
authors.initials: K
authors.lastname: Brismar
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hall
authors.forename: Mireille
authors.initials: M
authors.lastname: Vanpée
mesh_terms: D000328:Adult; D000886:Anthropometry; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D007333:Insulin Resistance; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D011247:Pregnancy; D055815:Young Adult
chemical_list: C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D008055:Lipids