Insulin Resistance in Short Children with Intrauterine Growth Retardation¹

TLDR

Intrauterine growth retardation is linked to a higher risk of adult diseases such as hypertension, type 2 diabetes, and heart disease, largely due to insulin resistance. The study aimed to determine whether short prepubertal children with IUGR exhibit abnormal insulin sensitivity compared to normal birth weight peers. Insulin sensitivity and related parameters were measured using a modified frequently sampled IV glucose tolerance test in both groups. IUGR children showed markedly lower insulin sensitivity and higher acute insulin response than controls, with no change in glucose effectiveness, indicating that impaired insulin sensitivity may serve as an early marker for later type 2 diabetes.

Abstract

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·(μU/mL); P = 0.0048]. The acute insulin response was also significantly different between groups, with IUGR subjects having higher insulin levels (445 vs. 174 μU/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.