Glucose and lipid metabolism in small-for-gestational-age infants at 72 hours of age.

Abstract

Reduced birth weight is associated with increased risk for the insulin resistance syndrome. Part of this risk is hypothesized to originate from intrauterine growth retardation. The aim of this study is to determine whether or not the components of the insulin resistance syndrome are associated with reduced fetal growth. This was a case-control study. The study was conducted in Beijing, China. Included in this study were 296 singleton neonates (177 males and 119 females), including 76 (37 preterm and 39 full-term newborns) classified as small for gestational age (SGA) and 220 who were appropriate for gestational age (AGA) (84 preterm and 136 full-term newborns). The main outcome measures were postabsorptive glucose, insulin, and lipids levels on the third day after birth. Both full-term and preterm SGA neonates had higher insulin concentrations (mean +/- SEM, 17.11 +/- 1.15 vs.6.80 +/- 0.62 microIU/ml in full-term, P < 0.01; 11.99 +/- 1.18 vs.8.37 +/- 0.78 microIU/ml in preterm, P = 0.03), insulin to glucose ratios (4.48 +/- 0.37 vs. 1.78 +/- 0.20 in full-term, P < 0.01; 3.28 +/- 0.38 vs. 2.30 +/- 0.26 in preterm, P = 0.03), triglycerides (2.29 +/- 0.23 vs.1.57 +/- 0.13 mmol/liter in full-term, P < 0.01; 2.27 +/- 0.16 vs. 1.34 +/- 0.11 mmol/liter in preterm, P < 0.01), total cholesterol (2.35 +/- 0.12 vs. 1.82 +/- 0.22 mmol/liter in full-term, P = 0.04; 2.57 +/- 0.22 vs. 1.95 +/- 0.15 mmol/liter in preterm, P = 0.02), and low-density lipoprotein cholesterol (2.11 +/- 0.58 vs. 1.24 +/- 0.61 mmol/liter in full-term, P = 0.01; 1.87 +/- 0.60 vs. 1.38 +/- 0.59 mmol/liter in preterm, P < 0.01) concentrations than did AGA neonates; however, they had similar glucose levels. Among AGA infants, insulin concentration, insulin to glucose ratios, and lipids levels did not significantly differ between full-term and preterm babies. In this study, SGA neonates displayed profiles suggestive of lower insulin sensitivity and less favorable lipid metabolism in the early postnatal period.