Insulin sensitivity in prematurely born adults: relation to preterm growth restraint.

OBJECTIVE

Preterm infants are at risk of developing insulin resistance. It is not known whether insulin resistance in adult life is different between those with a low weight at term (preterm growth restraint, PGR) and those with a normal weight at term.

STUDY DESIGN

Insulin sensitivity, measured by the hyperinsulinemic euglycemic clamp, was investigated in 21-year-old adults born very preterm (i.e. <32 gestational weeks), of whom 17 were small for gestational age (SGA), 12 were appropriate for gestational age with PGR (AGA-PGR) and 28 were AGA-non-PGR.

RESULTS

Insulin sensitivity expressed as M value (glucose disposal mg/kg/min) was lower in AGA-non-PGR (8.9) than in SGA (11.0) or AGA-PGR subjects (10.4). These differences disappeared after adjustment for current body size. Linear growth between 3 months and 21 years of age was different between AGA-non-PGR and SGA subjects and between AGA-nonPGR subjects and the combined AGA-PGR and SGA subjects.

CONCLUSION

In young adults born very preterm, differences in insulin sensitivity between those born SGA, with PGR and without PGR are related to the current body composition.