Does Gender-Specific BMI Development Modulate Insulin Sensitivity in Extremely Low Birth Weight Infants?

• Published in: Journal of Pediatric Endocrinology and Metabolism Vol. 22; no. 9; pp. 827 - 836
• Main Authors: Gohlke, B.C., Stutte, S., Bartmann, P., Woelfle, J.
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 01.09.2009
• Subjects: Birth Weight - physiology; Body Height - physiology; Body Mass Index; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant, Extremely Low Birth Weight - blood; Infant, Extremely Low Birth Weight - growth & development; Infant, Extremely Low Birth Weight - metabolism; Infant, Newborn; Infant, Small for Gestational Age - blood; Infant, Small for Gestational Age - growth & development; Infant, Small for Gestational Age - metabolism; Insulin Resistance - physiology; Insulin-Like Growth Factor Binding Protein 1 - blood; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor Binding Proteins - blood; Insulin-Like Growth Factor I - analysis; Male; Sex Characteristics
• ISSN: 0334-018X; 2191-0251
• DOI: 10.1515/JPEM.2009.22.9.827

Increasing numbers of extremely low birth weight infants (ELBW, birth weight < 1,000 g) survive. We studied the impact of birth weight, gender, and catch-up growth on metabolic parameters in ELBW infants. Sixty-three ELBW children were investigated at a mean age of 5.8 years. Forty-eight showed catch-up growth. ELBW children who were small for gestational age were significantly shorter than those whose size was appropriate for their gestational age (height SDS: -1.1 [SD 0.8] vs -0.4 [0.9]; p < 0.001). This corresponded with significantly lower standard deviation scores for IGF-I (-1.1 [1.3] vs 0.1 [0.8]; p < 0.05) and IGFBP-3 (-0.7 [1.7] vs 0.4 [1.1]; p < 0.05). No differences were found regarding fasting insulin, glucose, HOMA and IGFBP-1. The catch-up group showed lower IGFBP-1 concentrations than the non-catch-up group. IGFBP-1 decreased in individuals who became more insulin resistant. No differences were found regarding mean IGF-1 and IGFBP-3 SDS. A gender-related pattern was found for weight development: girls demonstrated a normalization of BMI from the age of 2 years whereas boys remained at a mean BMI of -1.96 SDS. Corresponding to this, girls showed lower IGFBP-1 levels than boys. Metabolic parameters in ELBW children are modulated by subsequent catch-up growth and sex-dependent weight development, resulting in measurable differences even in early childhood.