Department of Pediatrics, Seoul National University College of Medicine, Korea.
Endocr J. 2012;59(8):725-33. doi: 10.1507/endocrj.ej12-0080. Epub 2012 May 11.
Small for gestational age (SGA) at birth and postnatal growth pattern may have an impact on insulin resistance and body composition in their later life. Emerging evidence has indicated that insulin-like growth factor binding protein-2 (IGFBP-2) may be related to insulin sensitivity. The aim of this study was to evaluate insulin resistance and IGFBP-2 levels in SGA children, and to identify the effect of catch-up growth on IGFBP-2 concentration. Serum IGFBP-2 levels were measured in 103 Korean SGA children including 49 prepubertal and 54 pubertal subjects. Anthropometric values, fasting serum levels of metabolic parameters and insulin sensitivity indices were determined. Each prepubertal or pubertal group was subgrouped based on height or weight catch-up growth. The subgroups with weight catch-up showed higher values of BMI, body fat mass, percent body fat, and total cholesterol. Particularly in pubertal children, IGFBP-2 concentration was lower in the subgroup with weight catch-up. Catch-up growth in height did not affect insulin resistance and metabolic parameters. IGFBP-2 levels were inversely correlated with BMI, body fat mass, percent body fat, insulin and leptin levels in both prepubertal and pubertal groups. Additionally in the pubertal group, systolic blood pressure, cholesterol levels were related to IGFBP-2. A strong relationship between IGFBP-2, the insulin sensitivity index, and some cardiovascular risk factors was observed in children born SGA, suggesting that IGFBP-2 might be a promising marker for early recognition of insulin resistance, particularly in children with weight catch-up.
出生时小于胎龄儿(SGA)和生后生长模式可能对其以后的生活中的胰岛素抵抗和身体成分产生影响。新出现的证据表明,胰岛素样生长因子结合蛋白-2(IGFBP-2)可能与胰岛素敏感性有关。本研究旨在评估 SGA 儿童的胰岛素抵抗和 IGFBP-2 水平,并确定追赶生长对 IGFBP-2 浓度的影响。在 103 名韩国 SGA 儿童中测量了血清 IGFBP-2 水平,包括 49 名青春期前和 54 名青春期后儿童。测定了人体测量值、空腹代谢参数和胰岛素敏感性指数的血清水平。根据身高或体重追赶生长将每个青春期前或青春期组进一步分为亚组。体重追赶组的亚组具有更高的 BMI、体脂肪量、体脂肪百分比和总胆固醇值。特别是在青春期儿童中,体重追赶组的 IGFBP-2 浓度较低。身高的追赶生长不会影响胰岛素抵抗和代谢参数。IGFBP-2 水平与青春期前和青春期组的 BMI、体脂肪量、体脂肪百分比、胰岛素和瘦素水平呈负相关。此外,在青春期组中,收缩压、胆固醇水平与 IGFBP-2 相关。出生时 SGA 的儿童中 IGFBP-2 与胰岛素敏感性指数和一些心血管危险因素之间存在很强的关系,这表明 IGFBP-2 可能是识别胰岛素抵抗的有前途的标志物,尤其是在体重追赶的儿童中。