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Diabetologia. 2000 Jun;43(6):714-7.

Effects of size at birth, gestational age and early growth in preterm infants on glucose and insulin concentrations at 9-12 years.

Author information

1
University Department of Clinical Biochemistry, Addenbrooke's Hospital, Cambridge, UK.

Abstract

AIMS/HYPOTHESIS:

To test the hypothesis that small size for gestation and poor postnatal growth in preterm infants is associated with higher fasting and post-load plasma glucose and insulin concentrations at 9-12 years of age.

METHODS:

Prospective follow-up at 9-12 years of 385 preterm children with birth weight less than 1850 g, who had anthropometry recorded at birth, 18 months and 7 years. Fasting plasma glucose, insulin, proinsulin and 32.33 split proinsulin concentrations and glucose and insulin concentrations 30 min after a standard glucose load were measured.

RESULTS:

Post-load glucose concentrations were negatively related to birth weight, independently of gestation or subsequent growth. Fasting split proinsulin and 30-min insulin concentrations were highest in children who showed the greatest increase in weight centile between birth and current follow-up, regardless of gestation. When weight during childhood was included, birthweight centile was, however, no longer statistically significant: concentrations of fasting, split, proinsulin and 30-min insulin were highest in those children who had shown the greatest increase in weight centile between 18 months of age and current follow-up, with no evidence of a greater effect in those who were smallest at 18 months.

CONCLUSION/INTERPRETATION:

Our findings suggest that fetal growth influences plasma glucose 30 min after a glucose load in preterm children at 9-12 years. In contrast, childhood weight gain is the most important factor influencing insulin concentrations and this effect is the same regardless of early size.

PMID:
10907116
DOI:
10.1007/s001250051368
[Indexed for MEDLINE]

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