Low nutrient intake and early growth for later insulin resistance in adolescents born preterm.

Abstract

BACKGROUND:

In animals, acceleration of neonatal growth is thought to increase the later propensity to insulin resistance and non-insulin-dependent diabetes, whereas slow growth as a consequence of undernutrition is thought to have a beneficial effect. To test this hypothesis in people, we measured fasting concentrations of 32-33 split proinsulin, a marker of insulin resistance, in adolescents born preterm who had participated in randomised intervention trials of neonatal nutrition, and in adolescents born at term.

METHODS:

We determined fasting 32-33 split proinsulin concentration in participants aged 13-16 years born preterm and randomised to receive a nutrient-enriched or lower-nutrient diet (n=216) or in a reference group born at term (n=61).

FINDINGS:

Fasting 32-33 split proinsulin concentration was greater in children given a nutrient-enriched diet (geometric mean 7.2 pmol/L, 95% CI 6.4-8.1) than in those given the lower-nutrient diet (5.9 pmol/L [5.2-6.4]; mean difference 20.6% [5.0-36.3]; p=0.01). Healthy babies born at term had similar fasting 32-33 split proinsulin concentrations (6.9 pmol/L; 6.0-8.2) to the nutrient-enriched group. In non-randomised analyses, fasting 32-33 split proinsulin concentration was associated with greater weight gain the first 2 weeks of life (13.2% [5.4-20.9] change per 100 g weight increase; p=0.001) independent of birthweight, gestation, neonatal morbidity, and demographic, anthropometric, and socioeconomic factors.

INTERPRETATION:

Our results suggest that relative undernutrition early in life in children born preterm may have beneficial effects on insulin resistance.

• Authors: Atul Singhal, Mary Fewtrell, Tim J Cole, Alan Lucas
• Journal: Lancet (London, England) (Lancet) Vol. 361 Issue 9363 Pg. 1089-97 (Mar 29 2003) ISSN: 0140-6736 [Print] England
• PMID: 12672313 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Protein Precursors
• proinsulin, des(31,32)-
• Proinsulin

Topics

• Adolescent
• Body Height (physiology)
• Cardiovascular Diseases (physiopathology)
• Child
• Child, Preschool
• Cohort Studies
• Diabetes Mellitus, Type 2 (physiopathology)
• Follow-Up Studies
• Humans
• Infant
• Infant Nutritional Physiological Phenomena (physiology)
• Infant, Newborn
• Insulin Resistance (physiology)
• Proinsulin (blood)
• Protein Precursors (blood)
• Protein-Energy Malnutrition (physiopathology)
• Reference Values
• Risk Factors
• United Kingdom