ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P600

High incidence of obesity and insulin resistance in prepubertal children, born too small for their gestational age

Renata Stawerska, Malgorzata Szalapska, Joanna Smyczynska, Mciej Hilczer & Andrzej Lewinski

Chair Endocrinology and Metabolism Diseases Medical University of Lodz, Research Institute, Polish Mother Memorial Hospital, Lodz, Poland.

Fetal undernutrition is at the base of disorders in the differentiation process of pancreatic beta cells. Abnormal insulin activity leads to restriction of fetal growth and to obesity, insulin resistance and diabetes mellitus type 2 (DM2), either in childhood or adulthood. The aim of the study was to assess the incidence of obesity and insulin resistance in prepubertal children, born with body mass too small for their gestational age (SGA).

Material and methods: Sixty-eight (68) prepubertal children (aged form 6 to 10 years, born as SGA (the birth weight below −2.0 standard deviation for gestational age and sex), were enrolled into the study. The comparison group comprised twelve (12) healthy children, matched for age and sex, born with body weight appropriate for gestational age (AGA). In each child, its actual height and weight were measured and BMI was calculated, fasting cholesterol and triglycerides concentrations were assessed and glucose and insulin concentrations during oral glucose tolerance test (OGTT) were performed. Based on the results of OGTT, IR index, according to HOMA, and IR index, according to Belfiore, were calculated, too.

Results: Neither glucose intolerance nor DM2 was observed in any of the examined children. No lipid concentration disorders were found in any of the children. Obesity was recognized in 32.3% children with SGA. In about 50% of the children with SGA and obesity, insulin resistance was identified. No statistical correlation was observed between birth body mass and: glucose, insulin, cholesterol and triglycerides concentrations, however, a negative correlation was noted between birth body mass and IR indices.

Conclusion: Low birth body mass is a risk factor of obesity and insulin resistance in prepubertal children.

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