Abstract
BackgroundRecent studies have demonstrated that low and high birth-weight at birth are risk factors of developing diabetes. The aim of this study was to determine if the abnormal birth-weight is related with hyperinsulinemia and elevated index of the Homeostasis Model assessment for Insulin Resistance (HOMA-IR) at birth, in at term newborns.MethodsNewborns with gestational age between 38 and 41 weeks, products of normal pregnancies of healthy mothers aged 18 to 39 years, were eligible to participate. Small-for-gestational age (SGA) and large-for-gestational age (LGA) newborns were compared with appropriate-for-gestational (AGA) age newborns. Incomplete or unclear data about mother’s health status, diabetes, gestational diabetes, history of gestational diabetes, hypertension, pre-eclampsia, eclampsia, and other conditions that affect glucose metabolism were exclusion criteria. Hyperinsulinemia was defined by serum insulin levels ≥13.0 μU/mL and IR by HOMA-IR ≥2.60. Multiple logistic regression analysis was used to determine the odds ratio (OR) that computes the association between birth-weight (independent variable) with hyperinsulinemia and HOMA-IR index (dependent variables).ResultsA total of 107 newborns were enrolled; 13, 22, and 72 with SGA, LGA, and AGA, respectively. Hyperinsulinemia was identified in 2 (15.4%), 6 (27.3%), and 5 (6.9%) with SGA, LGA, and AGA (p=0.03), whereas IR in 3 (23.1%), 8 (36.4%), and 10 (13.9%) newborns with SGA, LGA and AGA (p=0.06). The LGA showed a strong association with hyperinsulinemia (OR 5.02; CI 95%, 1.15-22.3; p=0.01) and HOMA-IR (OR 3.54; CI 95%, 1.03-12.16; p=0.02); although without statistical significance, the SGA showed a tendency of association with hyperinsulinemia (OR 2.43; CI 95%, 0.43-17.3 p=0.29) and HOMA-IR (OR 1.86; CI 95%, 0.33-9.37; p=0.41).ConclusionsOur results suggest that LGA is associated with hyperinsulinemia and elevated HOMA-IR at birth whereas the SGA show a tendency of association.
Highlights
Recent studies have demonstrated that low and high birth-weight at birth are risk factors of developing diabetes
With the purpose of establish the cutoff point of Homeostasis Model assessment for Insulin Resistance (HOMA-IR) at birth in appropriate-forgestational age (AGA) newborns delivered at term, a total of 150 newborns with birth-weight greater than 2500 g and lower that 4000 g, were enrolled in a crosssectional non-comparative study
An independent sample of 107 newborns were enrolled in a cross-sectional comparative study to determine if large-for-gestational age (LGA) or small-for-gestational age (SGA) is related with hyperinsulinemia and elevated HOMA-IR in newborns delivered at term
Summary
Recent studies have demonstrated that low and high birth-weight at birth are risk factors of developing diabetes. Recent studies have demonstrated that low birthweight is a risk factor for development of obesity and type 2 diabetes in adulthood [2], association that could be explained because during intrauterine growth the fetus does not promote the appropriate growth of beta cells [3,4]. Children with history of high birthweight have an elevated risk of developing obesity and type 2 diabetes later in life [5,6,7]. In addition to genetic predisposition, nutritional, and environmental factors, it has been reported that the elevated levels of cytokines increase glucocorticoid activity and decrease serum adiponectin during pregnancy, which affects birth-weight [8,9,10,11]. It has been reported that conditions that modify insulin concentration during fetal life could alter the normal development of endocrine system, predisposing to insulin resistance in adult life [16,17]
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