scholarly journals Serum glucocorticoids and adiponectin associate with insulin resistance in children born small for gestational age

2010 ◽  
Vol 162 (3) ◽  
pp. 551-557 ◽  
Author(s):  
S Tenhola ◽  
B Todorova ◽  
J Jääskeläinen ◽  
O A Jänne ◽  
T Raivio ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Serum Cortisol ◽  
Serum Adiponectin ◽  
Model Assessment ◽  
Free Cortisol ◽  
Appropriate For Gestational Age ◽  
The Mean ◽  
And Gender

ObjectivesAltered glucocorticoid activity is one possible mechanism linking fetal growth restriction with later insulin resistance (IR) and type 2 diabetes. We aimed to investigate whether serum glucocorticoid parameters are related to IR in children born small for gestational age (SGA).DesignA total of 110 children (55 age- and gender-matched pairs born SGA or appropriate for gestational age (AGA) in a case–control setting) were studied at the mean age of 12.2 (s.d. 0.2) years.MethodsSerum cortisol, corticosteroid-binding globulin (CBG), free cortisol index (FCI=cortisol/CBG), and glucocorticoid bioactivity (GBA, transactivation assay) were analyzed and related to serum adiponectin and insulin-like growth factor-binding protein 1 (IGFBP1) concentrations and homeostasis model assessment for IR (HOMA-IR) and QUICKI indices.ResultsIn the pooled study population, GBA correlated well with cortisol and FCI (r=0.681 and 0.586 respectively; P<0.001 for both). Serum cortisol, CBG, FCI, GBA, HOMA-IR, or QUICKI did not differ between the SGA and AGA subjects, but the SGA children had lower body mass index (P=0.005) and waist circumference (WC) (P=0.001). The mean GBA in the highest GBA quartile was higher among the SGA subjects than among the AGA subjects (138.6 vs 96.4 nmol/l cortisol equivalents, P<0.001). In the SGA children, GBA correlated positively with HOMA-IR (r=0.522, P<0.001) and inversely with adiponectin (r=−0.278, P=0.042) (WC/height ratio adjustments), and in logistic regression analysis, higher GBA (odds ratio (OR) 1.3; P=0.013), lower adiponectin (OR 1.4; P=0.038), and lower IGFBP1 (OR 1.9; P=0.010) associated independently with higher HOMA-IR.ConclusionsThese findings suggest that increased glucocorticoid activity and low serum adiponectin concentrations associate with IR in SGA children.

Hormonal regulation of postnatal growth from birth to age six months in Small-for-Gestational - Age children

2016 ◽  
Vol 7 (3) ◽  
pp. 104-110
Author(s):  
Kristina F Islamova ◽  
Dmitriy O Ivanov ◽  
Yuriy V Petrenko ◽  
Elizaveta A Kurzina
Keyword(s):  
Insulin Sensitivity ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Hormonal Regulation ◽  
Later Life ◽  
Postnatal Growth ◽  
Blood Levels ◽  
Model Assessment ◽  
Appropriate For Gestational Age ◽  
Catch Up

This article is devoted to the investigation hormonal mechanisms of postnatal growth from birth to age six months in small for gestational age children (SGA) with asymmetrical and asymmetrical IUGR. The IGF-1 and GH levels, insulin sensitivity (by homeostasis model assessment (HOMA-IR)) were measured blood at 3 and 6 months of age. The prospective study includes 40 SGA infants (group 1) - 24 - with asymmetrical (1a) and 16 with symmetrical IUGR babies (1b) and 17 appropriate for gestational age (AGA) infants (group 2). Most SGA infants showed rapid, or “catch-up” postnatal growth. Symmetrical IUGR infants with “catch-up” growth had higher IGF-1 and growth GH levels at 3 month of age than asymmetrical IUGR with “catch-up” growth (p < 0,05). From 3 to 6 months of age 77 % of infants with “catch-up” growth showed retardation of growth velocity. At 6 month of age SGA infants with “catch-up” growth had lower IGF-1, GH blood levels and HOMA-IR than at 3 months of age (p < 0,05). Infants without “catch-up” growth had similar hormone levels at 3 and 6 months of age. We suppose, that these changes of “GH - IGF-1” axis and insulin sensitivity at age 3 and 6 months in SGA infants are the mechanisms, which promote the postnatal growth. It can be assumed that the same mechanisms may underlie metabolic disorders in later life.

Cardiac autonomic balance in small-for-gestational-age neonates

2008 ◽  
Vol 294 (2) ◽  
pp. H884-H890 ◽  
Author(s):  
Leonhard Schäffer ◽  
Tilo Burkhardt ◽  
Deborah Müller-Vizentini ◽  
Manfred Rauh ◽  
Maren Tomaske ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Low Frequency ◽  
Postnatal Life ◽  
Sympathovagal Balance ◽  
Response Patterns ◽  
Key Factor ◽  
Appropriate For Gestational Age ◽  
The Mean ◽  
Cardiac Autonomic Activity

The cardiac sympathetic nervous system is one putative key factor involved in the intrauterine programming of adult cardiovascular disease. We therefore analyzed cardiac autonomic system activity in small for gestational age (SGA) neonates. Heart rate variability (HRV) from 24-h ECG recordings were analyzed for time-domain and frequency-domain parameters in 27 SGA neonates [median 261 (240–283) days of gestation] compared with 27 appropriate for gestational age (AGA) neonates [median 270 (239–293) days of gestation]. In addition, salivary α-amylase levels were analyzed during resting conditions and in response to a pain-induced stress event in 18 SGA [median 266 (240–292) days of gestation] and 34 AGA [median 271 (240–294) days of gestation] neonates. Overall HRV was not significantly different in SGA neonates compared with AGA neonates (SD of all valid NN intervals: P = 0.14; triangular index: P = 0.29), and the sympathovagal balance [low frequency (LF)/high frequency (HF)] was similar ( P = 0.62). Parameters mostly influenced by sympathetic activity did not reveal significant differences: (SD of the average of valid NN intervals: P = 0.27; average of the hourly means of SDs of all NN intervals: P = 0.66, LF: P = 0.83) as well as vagal tone-influenced parameters were unaltered (average of the hourly square root of the mean of the sum of the squares of differences between adjacent NN intervals: P = 0.59; proportion of pairs of adjacent NN intervals differing by >50 ms: P = 0.93; HF: P = 0.82). Median resting levels for α-amylase were not significantly different in SGA neonates ( P = 0.13), and a neonatal stress stimulus revealed similar stress response patterns ( P = 0.29). HRV and salivary α-amylase levels as indicators of cardiac autonomic activity were not altered in SGA neonates compared with AGA neonates. Thus, it appears that the intrauterine activation of the sympathetic system in SGA fetuses does not directly persist into postnatal life, and neonatal sympathovagal balance appears to be preserved.

scholarly journals Accuracy of Ultrasound Estimated Fetal Weight in Small for Gestational Age and Appropriate for Gestational Age Grown Periviable Neonates

2017 ◽  
Vol 35 (08) ◽  
pp. 703-706
Author(s):  
Katherine Himes ◽  
Adriane Haragan
Keyword(s):  
Birth Weight ◽  
Study Design ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Weight ◽  
Percentage Difference ◽  
Appropriate For Gestational Age ◽  
Absolute Percentage Difference ◽  
The Mean ◽  
Estimated Fetal Weight

Objective Clinicians use estimated fetal weight (EFW) as a proxy for birth weight (BW) in the antenatal period. Our objective was to compare the accuracy of EFW obtained by ultrasound to BW among infants born during the periviable period and determine if accuracy of EFW varied among small for gestational age (SGA) versus appropriate for gestational age (AGA) grown neonates. Study Design We included women who delivered between 230/7 and 256/7 weeks' gestation and had an EFW within 7 days of delivery. Mean percentage difference and median absolute percentage difference between EFW and BW were calculated. Results Our cohort included 226 neonates with a mean gestational age of 241/7 ± 0.8 weeks and median BW of 653 g (interquartile range [IQR]: 580–750 g). The median absolute percentage difference between EFW and BW of fetal weight estimates was 9.2% (IQR: 3.6–17.2). EFW overestimated BW for 75% (n = 171) of the cohort. Among SGA infants, the mean percentage difference in EFW and BW was 16.2 ± 19.4% versus 6.9% ± 13.1% in AGA infants (p = 0.019). Conclusion EFW overestimated BW in this cohort. In addition, ultrasound was less accurate among infants born SGA. These data are important to consider when counseling families facing periviable delivery.

Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age

2012 ◽  
Vol 101 (12) ◽  
pp. 1217-1224 ◽  
Author(s):  
Anna Kistner ◽  
Alexander Rakow ◽  
Lena Legnevall ◽  
Giovanna Marchini ◽  
Kerstin Brismar ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Appropriate For Gestational Age ◽  
Resistance Markers

scholarly journals Leptin and adiponectin concentrations in intrauterine growth restricted and appropriate for gestational age fetuses, neonates, and their mothers

2008 ◽  
Vol 158 (3) ◽  
pp. 343-348 ◽  
Author(s):  
Marialena Kyriakakou ◽  
Ariadne Malamitsi-Puchner ◽  
Helen Militsi ◽  
Theodora Boutsikou ◽  
Alexandra Margeli ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gestational Age ◽  
Critical Role ◽  
Adult Life ◽  
Subsequent Development ◽  
Serum Cortisol ◽  
Serum Levels ◽  
Intrauterine Growth ◽  
The Metabolic Syndrome ◽  
Appropriate For Gestational Age

ObjectiveLeptin and adiponectin are two adipocytokines that play a critical role in the control of energy balance and metabolism as well as in conditions, such as insulin resistance, inflammation, and the development of the metabolic syndrome in adult life. Leptin has been associated with asymmetric intrauterine growth restriction (IUGR). The aim of this study was to investigate the perinatal implication of leptin and adiponectin in IUGR.DesignLeptin and adiponectin were measured in the plasma of 40 mothers, in the umbilical cord (UC) blood of their 20 appropriate for gestational age (AGA) and 20 IUGR singleton, full-term fetuses, and neonates on day 1 (d1) and day 4 (d4) of life postnatally.MethodsSerum leptin and adiponectin levels were measured by RIA. Serum cortisol levels were measured with an electrochemiluminescence immunoassay.ResultsLeptin and adiponectin serum levels were higher and lower respectively in IUGR (mean±s.e.m., 32.5±3.8 and 5.4±0.9 μg/l respectively) compared with AGA (20.4±2.1 and 11.8±1.3 μg/l respectively) mothers (P<0.05), although body mass index did not differ between these two groups. Leptin levels positively correlated with adiponectin levels in the AGA (r=0.547, P<0.05) but not in the IUGR mothers. UC, d1, and d4 leptin and adiponectin levels did not differ between IUGR and AGA groups. UC were significantly higher than d1 leptin levels (P<0.05) in the IUGR group but not in the AGA group.ConclusionsThe increased UC leptin levels compared with d1 in IUGR fetuses might be directly and/or indirectly related to the subsequent development of insulin resistance in these neonates. This pathologic situation seems to be related to a specific profile of increased leptin and decreased adiponectin levels in IUGR mothers indicating a genetic predisposition for the development of insulin resistance.

scholarly journals Serum adiponectin levels, insulin resistance, and lipid profile in children born small for gestational age are affected by the severity of growth retardation at birth

2007 ◽  
Vol 156 (2) ◽  
pp. 271-277 ◽  
Author(s):  
Eleni N Evagelidou ◽  
Vasileios I Giapros ◽  
Anna S Challa ◽  
Dimitrios N Kiortsis ◽  
Agathocles A Tsatsoulis ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Lipid Profile ◽  
Gestational Age ◽  
Growth Retardation ◽  
Small For Gestational Age ◽  
Density Lipoprotein ◽  
Model Assessment ◽  
Apo B ◽  
Significant Difference ◽  
Catch Up

Objective: Insulin resistance has been linked to intrauterine growth retardation (IUGR); adiponectin is a protein with insulin-sensitizing properties. This study was designed to test whether being born small for gestational age (SGA) has an effect on blood levels of adiponectin and leptin, insulin resistance parameters, and lipid profile in pre-puberty, taking into consideration the severity of IUGR. Methods: Serum levels of adiponectin, leptin, total cholesterol (t-CHOL), high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides, apolipoproteins A-1 (Apo A-1), Apo B and Apo E, lipoprotein(a) (Lp(a)), fasting glucose, and insulin (Ins), the homeostasis model assessment insulin resistance index (HOMA-IR) and anthropometric indices were evaluated in 70 children aged 6–8 years, born appropriate for gestational age (AGA; n = 35) and SGA (n = 35), matched for age, gender, height, and BMI. SGA children were divided into two subgroups according to the severity of IUGR: SGA<3rd percentile (n = 20), and SGA 3rd–10th percentile (n = 15). They were also subdivided in two subgroups, those with (n = 25) and those without (n = 10) catch-up growth, considering their actual height corrected for mid-parental height. Results: SGA children had higher Ins and HOMA-IR than AGA children (Ins, 42 ± 23 vs 32 ± 11 pmol/l; HOMA-IR, 1.30 ± 0.8 vs 0.92 ± 0.3; P<0.05). No significant difference in serum leptin was found between the SGA and the AGA groups but adiponectin showed a trend to be higher in SGA children (13.6 ± 5.7 vs 10.8 ± 5.9 μg/ml respectively). SGA children without catch-up growth had higher adiponectin (15.6 ± 8.5 μg/ml, P<0.05) than AGA children. Among the SGA children, the subgroup <3rd percentile had higher Lp(a) than the subgroup 3rd–10th percentile (P<0.05). An independent positive correlation between adiponectin and Lp(a) was observed in SGA children (R = 0.59, P<0.01). Conclusion: SGA children, although more insulin resistant, had similar or higher adiponectin levels than matched AGA children in pre-puberty. The severity of IUGR appears to affect their metabolic profile during childhood.

scholarly journals Homeostasis Model Assessment - Insulin Resistance and Sensitivity (HOMA-IR and IS) Index in Overweight Children Born Small for Gestational Age (SGA)

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 83-89
Author(s):  
Aleksandra Janchevska ◽  
Zoran Gucev ◽  
Velibor Tasic ◽  
Momir Polenakovic
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Birth Weight ◽  
Gestational Age ◽  
Model Assessment ◽  
Normal Birth Weight ◽  
Obese Children ◽  
Homeostasis Model Assessment ◽  
Normal Birth ◽  
The Mean

Abstract Introduction: Children born small for gestational age (SGA) have increased prevalence of metabolic syndrome, diabetes mellitus type 2 (DM2), hypertension and cardiovascular and cerebrovascular events in adulthood. Patients and Methods: In 100 children born SGA, and in second cohort having 32 obese children born in term with normal birth weight and height, anthropometric measurements and biochemical metabolic profiles were analysed. The Homeostasis Model Assessment - Insulin Resistance and Sensitivity (HOMA-IR and IS) were calculated. Results: Four overweight/obese children (M:F=3:1) with normal height were found among 100 SGA children. The body mass index (BMI) in all 4 children was above the 98th percentile and the mean BMI z-score was (2.04±0.30 SDS). The HOMA-IR index in all four children was increased: 1.26-2.65 (>1). Two teenagers had significant hyperinsulinemia (198.00 uIU/ml and 275 uIU/ml) and were treated with metformin. Two girls needed only a diet and increased physical activity. The mean values of HOMA-IR (1.26-2.65; N< 1) and IS (58 ±17.12) in fo-ur SGA overweight/obese children who caught-up growth had indistinguishable values with the group of 32 (M: F=21:11) obese children (HOMA-IR 1.83±1.2 SDS; IS 82.99±64.53 SDS) born in term with normal birth weight and height. Conclusions: SGA born children are usually thin; nevertheless we found overweight and obesity in 4% of the patients. Two of those children have metabolic syndrome. Excess weight, obesity and metabolic syndrome in SGA children result with increase of their inherent risk for DM2, cardiovascular and cerebrovascular diseases in adulthood.

Eccentric placentae have reduced surface area and are associated with lower birth weight in babies small for gestational age

2018 ◽  
Vol 9 (3) ◽  
pp. 281-286 ◽  
Author(s):  
G. Ravikumar ◽  
J. Crasta ◽  
J. S. Prabhu ◽  
T. Thomas ◽  
P. Dwarkanath ◽  
...  
Keyword(s):  
Birth Weight ◽  
Surface Area ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Singleton Pregnancy ◽  
Appropriate For Gestational Age ◽  
The Mean ◽  
Placental Efficiency ◽  
Clinical Records

AbstractPlacental structure and function determine birth outcomes. Placental mass does not always correlate with fetal birth weight (BW) in uncomplicated pregnancies which raises the possibility of other variables such as placental shape and cord insertion being the determinants of placental efficiency. In total, 160 women with singleton pregnancy, recruited into a pregnancy cohort were studied. Placental weight (PW) was measured and other data were obtained from clinical records. Birth outcomes were classified as small for gestational age (SGA) and appropriate for gestational age (AGA) based on fetal gender, gestational age (GA) and BW. High-resolution images of the chorionic plate were recorded. The shape of the placenta and the insertion of the cord were measured using eccentricity index (EI) and cord centrality index (CCI). Only placentae with eccentrically inserted cords (n=136) were included. The mean BW and PW were 2942 (±435) g and 414 (±82) g with average GA of 38.6 weeks. The mean CCI and EI was 0.483 (±0.17) and 0.482 (±0.16). Neither of these correlated with placental efficiency. However, EI showed negative correlation with placental surface area and breadth. Upon sub-grouping the cohort into SGA (n=32) and AGA (n=104), the SGA babies with the highest EI (third tertile) had significantly lower BW than those with the least eccentric placentae (first tertile). Although eccentric-shaped placentae were present in both SGA and AGA groups, the effect on BW was observed only in the SGA group.

scholarly journals Associations of Size at Birth and Metabolic Syndrome Antecedents With Serum Spexin Levels in Prepubertal Children

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A709-A710
Author(s):  
Fatma Duygu Ozturk Onsal ◽  
Ahmet Ucar ◽  
Ali Bulbul ◽  
Zeynep Yildiz Yildirmak ◽  
Gizem Kara Elitok
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Model Assessment ◽  
Prepubertal Children ◽  
Excess Adiposity ◽  
Significant Difference ◽  
Idefics Study ◽  
Size At Birth

Abstract Background: Spexin is a novel peptide implicated in food intake and obesity. The primary aim of this study was to analyze whether serum spexin levels, along with total leptin and active ghrelin levels were different in prepubertal children born small for gestational age(SGA) and appropriate for gestational(AGA). Secondary aims were to analyze whether serum spexin, leptin and active ghrelin levels correlated with metabolic syndrome(MS)antecedents according to the Dietary and lifestyle-induced health effects in children and infants (IDEFICS)study. Subjects and Methods: We conducted a cross-sectional study on prepubertal37SGA- (median:5.6yr)and50prepubertalAGA-born children(median:5.9yr). Anthropometric data, homeostasis model assessment of insulin resistance(HOMAIR),plasma lipids, serum spexin, total leptin and active ghrelin levels were analyzed. Associations of serum spexin levels with MS antecedents according to the IDEFICS study were investigated. Results: Children bornSGA had higher body mass index and waist circumference than AGA-born peers(p &lt;0.05). Serum total leptin levels were higher in SGA-born children than in AGA-born peers (p&lt;0.05). Plasma active ghrelin and spexin levels were not different between the subgroups(p&gt;0.05). Children bornSGA had higher MS risk scores than AGA-born peers(p &lt;0.05). Small for gestational age- born children had higher plasma glucose,insulin and HOMA-IR than AGA-born peers(p&lt;0.05). In children born SGA, the number of subjects with excess adiposity (NSGA=18(43.9%)andNAGA=7(14%),p=0.016)and insulin resistance(NSGA=14(34%) andNAGA=6(12%),p=0.035)was higher than in AGA-born peers. There was no significant difference in frequency of dyslipidemia between the subgroups(p=0.19). The frequency of children with more than one MS antecedent was higher in SGA-born children than in AGA-born peers(Chi-Square p &lt;0.01). Metabolic syndrome risk score according to IDEFICS was higher in SGA born children than in AGA-born peers(2.2±1.8vs1.1±1.8;p=0.008). Serum spexin levels were lower in children with MS antecedents than those without MS antecedents in both AGA -and SGA-born children[Serum spexin levels in AGA-born children with and without MS antecedents: 48,5pg/mL(25-75%IQR:19.8-93.8pg/mL)and143pg/mL(25-75%IQR:104-211pg/mL),p&lt;0.001;respectively, serum spexin levels inSGAborn children with and without MS antecedents: 31,0pg/mL(25-75%IQR:16.5-47.0 pg/mL) and79.5pg/mL(25-75% IQR:49.5-274.8pg/mL),p=0,0016;respectively]. In the whole study group, the most important factor associated with excess adiposity was history of being born SGA(OddsRatio=91.3[95%CI:2.2-374;p=0.017] Conclusions: Serum spexin levels were not different inSGA- and AGA-born children. Serum spexin levels were reduced in children with MS antecedents independent of size at birth.

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