Background The association between small size at birth and impairedglucose regulation later in life is well established in personsborn at term. Preterm birth with very low birth weight (<1500g) is also associated with insulin resistance in childhood.If insulin resistance persists into adulthood, preterm birthwith very low birth weight also may be associated with an increasedrisk of disease in adulthood. We assessed glucose toleranceand insulin sensitivity and measured serum lipid levels andblood pressure in young adults with very low birth weight.
Methods We performed a standard 75-g oral glucose-tolerancetest, measuring insulin and glucose concentrations at baselineand at 120 minutes in 163 young adults (age range, 18 to 27years) with very low birth weight and in 169 subjects who hadbeen born at term and were not small for gestational age. Thetwo groups were similar with regard to age, sex, and birth hospital.We measured blood pressure and serum lipid levels, and in 150very-low-birth-weight subjects and 136 subjects born at term,we also measured body composition by means of dual-energy x-rayabsorptiometry.
Results As compared with the subjects born at term, the very-low-birth-weightsubjects had a 6.7% increase in the 2-hour glucose concentration(95% confidence interval [CI], 0.8 to 12.9), a 16.7% increasein the fasting insulin concentration (95% CI, 4.6 to 30.2),a 40.0% increase in the 2-hour insulin concentration (95% CI,17.5 to 66.8), an 18.9% increase in the insulin-resistance indexdetermined by homeostatic model assessment (95% CI, 5.7 to 33.7),and an increase of 4.8 mm Hg in systolic blood pressure (95%CI, 2.1 to 7.4). Adjustment for the lower lean body mass inthe very-low-birth-weight subjects did not attenuate these relationships.
Conclusions Young adults with a very low birth weight have higherindexes of insulin resistance and glucose intolerance and higherblood pressure than those born at term.
Source Information
From the Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki (P.H., J.G.E., S.S.-K., E.K.); the Hospital for Children and Adolescents, Institute of Clinical Medicine, University of Helsinki (P.H., S.A., A.-L.J., S.S.-K., O.M., E.K.); and the Department of Public Health (J.G.E.), University of Helsinki.
Address reprint requests to Dr. Hovi at the National Public Health Institute, Mannerheimintie 166, FI-00300 Helsinki, Finland, or at petteri.hovi{at}helsinki.fi.
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