title: Metabolic response to 36 hours of fasting in young men born small vs appropriate for gestational age.
abstract: OBJECTIVE
  Being born small for gestational age (SGA) is associated with an increased risk of type 2 diabetes in an affluent society, but could confer an improved chance of survival during sparse living conditions. We studied whether insulin action and other metabolic responses to prolonged fasting differed between 21 young adults born SGA and 18 matched controls born appropriate for gestational age (AGA).
  
  
  METHODS
  A frequently sampled IVGTT and indirect calorimetry measurements were performed after a 36 h fast. Endogenous glucose production, insulin sensitivity (SI), first-phase insulin secretion and glucose effectiveness were estimated by stable isotope tracer techniques and minimal modelling. Muscle and fat biopsies were obtained after 35 h of fasting.
  
  
  RESULTS
  During fasting, SGA individuals experienced a more pronounced decrease in serum insulin and lower plasma triacylglycerol levels compared with AGA individuals. In addition, energy expenditure decreased in SGA but increased in AGA individuals. After fasting, SGA individuals displayed lower fat oxidation than AGA individuals. SG was reduced in SGA compared with AGA individuals, whereas hepatic or whole body insulin action (SI) did not differ between groups. SGA individuals had increased muscle PPARGC1A DNA methylation. We found no differences in adipose tissue PPARGC1A DNA methylation, muscle and adipose tissue PPARGC1A mRNA expression, or muscle glycogen levels between the groups.
  
  
  CONCLUSIONS
  Compared with AGA individuals, SGA individuals displayed a more energy-conserving and potentially beneficial [corrected] cardiometabolic response to 36 h fasting. The role of increased muscle PPARGC1A DNA methylation in mediating this response requires further study.
authors.affiliation: Department of Endocrinology (Diabetes and Metabolism), Rigshospitalet, Tagensvej 20, 2200, Copenhagen N, Denmark, sinewanda@gmail.com.
authors.forename: Sine W
authors.initials: SW
authors.lastname: Jørgensen
authors.forename: Charlotte
authors.initials: C
authors.lastname: Brøns
authors.forename: Les
authors.initials: L
authors.lastname: Bluck
authors.forename: Line
authors.initials: L
authors.lastname: Hjort
authors.forename: Kristine
authors.initials: K
authors.lastname: Færch
authors.forename: Ajay
authors.initials: A
authors.lastname: Thankamony
authors.forename: Linn
authors.initials: L
authors.lastname: Gillberg
authors.forename: Martin
authors.initials: M
authors.lastname: Friedrichsen
authors.forename: David B
authors.initials: DB
authors.lastname: Dunger
authors.forename: Allan A
authors.initials: AA
authors.lastname: Vaag
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D004734:Energy Metabolism; D005215:Fasting / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D011247:Pregnancy; D013997:Time Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose