INSULIN RESISTANCE IN 7 YEAR OLD CHILDREN WHO WERE THIN AT BIRTH

Abstract

It has been shown recently that men and women who were thin at birth have a high prevalence of impaired glucose tolerance and insulin resistance. These associations may reflect impaired development of skeletal muscle during gestation. To determine whether the relations can be detected in children, we have studied a population sample of 249 British children aged 7 years. Blood was taken for glucose and insulin in the fasting state and 30 minutes after an oral glucose challenge. Plasma insulin, proinsulin, and 32-33 split proinsulin concentrations were determined by two site immunoreactive assays. Mean birthweight was 3359 (sd 510) grams. Glucose at 30 minutes was significantly inversely related to thinness at birth, as measured by the ponderal index (weight/height3). For a given insulin response to the glucose challenge, children who had been thin at birth had high glucose levels at 30 minutes. A high level of 32-33 split proinsulin, a measure of islet cell dysfunction, was related to shortness at birth. Those findings are further evidence that reduced growth in utero is followed by permanent dysfunction of the endocrine pancreas and resistance of peripheral tissues to insulin.