Low birth weight and insulin resistance in mid and late childhood
Gupta, M.; Gupta, R.; Pareek, A.; Bhatia, R.; Kaul, V.
Indian Pediatrics 44(3): 177-184
2007
ISSN/ISBN: 0019-6061 PMID: 17413193 Document Number: 613544
Objective: To correlate low birth weight with insulin resistance in mid and late childhood. Methods: Children whose birth weight records were available were successively enrolled from middle and low socioeconomic status urban schools in [Rajasthan] India. 600 children (aged 5-16 years) from 6 schools were screened for availability of recorded birth weight. Detailed birth weight records were available for 158 children born full term. The parents of 134 (84.8%) children agreed to participate in the study after informed consent. These children were evaluated for various anthropometric indices and fasting blood was obtained for determination of glucose and insulin levels. Insulin resistance was determined using the homeostasis model assessment (HOMA) and HOMA-2 formula. Comparative, univariate and multivariate statistical analyses were performed. Results: The mean age of the children was 10.0+or-2.4 years. Maternal diabetes was present in 3 (2.2%). Mean weight at birth was 2.84+or-0.61 kg, and 49 children (36.6%) had low birth weight (<2.5 kg). There was no statistically significant difference in current height, weight, body mass index, waist, hip, waist-hip ratio, mid upper arm circumference and systolic and diastolic blood pressure in children born with low or normal birth weight (P>0.10). Children with low birth weight had greater values for the following parameters than those with normal birth weight: mean fasting blood glucose, 80.1+or-16.1 vs. 70.1+or-14.8 mg/dl, P=0.042; median (interquartile range) fasting insulin levels, 10.18 (6.08-18.54) vs. 2.12 (0.02-7.45) micro U/ml, Mann-Whitney U test P<0.0001; and HOMA-derived insulin resistance, 1.88 (1.06-4.52) vs. 0.35 (0.02-1.52), P<0.0001. There was a significant negative correlation between birth weight and fasting insulin levels after multifactorial adjustments (partial correlation coefficient r=-0.436, P<0.001). Multivariate conditional logistic regression analysis revealed that birth weight was a significant determinant of fasting insulin levels after adjusting for age, gender, body mass index, waist and waist hip ratio (odds ratio, 3.82; 95% confidence interval: 1.16-12.63; P=0.028). Conclusions: Children born with low birth weight have significantly greater fasting glucose, fasting insulin levels and insulin resistance at mid and late childhood.