Insulin resistance in short children with intrauterine growth retardation

• Published in: The journal of clinical endocrinology and metabolism Vol. 82; no. 2; pp. 402 - 406
• Main Authors: HOFMAN, P. L, CUTFIELD, W. S, ROBINSON, E. M, BERGMAN, R. N, MENON, R. K, SPERLING, M. A, GLUCKMAN, P. D
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.02.1997
• Subjects: Biological and medical sciences; Birth Weight; Blood Glucose - metabolism; Body Height; Child; Child, Preschool; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fetal Growth Retardation - pathology; Fetal Growth Retardation - physiopathology; Glucose Intolerance; Humans; Insulin Resistance; Male; Medical sciences; Reference Values; Endocrinopathy; Human; Pancreatic hormone; Pregnancy disorders; Pathogenesis; Insulin; Growth retardation; Protein hormone; Target tissue resistance; Fetal diseases; Association; Fetal hypotrophy; Prepuberty; Risk factor; Child; Comparative study
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.82.2.402

Epidemiological studies have demonstrated an association between intrauterine growth retardation and an increased risk of adult diseases that include essential hypertension, noninsulin-dependent diabetes mellitus, and ischemic heart disease. A common feature of these diseases is insulin resistance. To investigate whether abnormal insulin sensitivity was a characteristic of subjects with intrauterine growth retardation (IUGR), we compared two groups of short prepubertal children: a group with IUGR (birth weight less than the tenth percentile; n = 15) and a normal birth weight group (n = 12). Subjects underwent a modified frequently sampled iv glucose tolerance test that permitted calculation of the acute insulin response, insulin sensitivity index, and glucose effectiveness. A marked difference in the insulin sensitivity index was noted between groups, with the IUGR group being less insulin sensitive [6.9 vs. 16.9 10(-4)min-1.(microU/mL); P = 0.0048]. The acute insulin response was also significantly different between groups, with IUGR subjects having higher insulin levels (445 vs. 174 microU/mL; P = 0.005). There was no difference in glucose effectiveness between groups. Short prepubertal IUGR children have a specific impairment in insulin sensitivity compared to their normal birth weight peers. In short IUGR children, impaired insulin sensitivity is a potential marker for the early identification and intervention in the development of late adult-onset noninsulin-dependent diabetes mellitus.