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Insulin resistance prior to term age in very low birthweight infants: a prospective study
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0001-9086-7991
Umeå University, Faculty of Social Sciences, Department of Food, Nutrition and Culinary Science.ORCID iD: 0000-0002-4649-0653
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0003-1816-4305
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0001-6090-494x
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2024 (English)In: BMJ Paediatrics Open, E-ISSN 2399-9772, Vol. 8, no 1, article id e002470Article in journal (Refereed) Published
Abstract [en]

Objective: To explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period.

Design: A prospective observational study—the Very Low Birth Weight Infants, Glucose and Hormonal Profiles over Time study.

Setting: A tertiary neonatal intensive care unit and four neonatal units in county hospitals in Sweden.

Patients: 48 infants born <1500 g (VLBW) during 2016–2019.

Outcome measures: Plasma concentrations of glucose-related hormones and proteins (C-peptide, insulin, ghrelin, glucagon-like peptide 1 (GLP-1), glucagon, leptin, resistin and proinsulin), insulin:C-peptide and proinsulin:insulin ratios, Homoeostatic Model Assessment 2 (HOMA2) and Quantitative Insulin Sensitivity Check (QUICKI) indices, measured on day of life (DOL) 7 and at postmenstrual age 36 weeks.

Results: Lower gestational age was significantly associated with higher glucose, C-peptide, insulin, proinsulin, leptin, ghrelin, resistin and GLP-1 concentrations, increased HOMA2 index, and decreased QUICKI index and proinsulin:insulin ratio. Hyperglycaemic infants had significantly higher glucose, C-peptide, insulin, leptin and proinsulin concentrations, and lower QUICKI index, than normoglycaemic infants. Higher glucose and proinsulin concentrations and insulin:C-peptide ratio, and lower QUICKI index on DOL 7 were significantly associated with longer duration of hyperglycaemia during the admission period.

Conclusions: VLBW infants seem to have a hormone profile consistent with insulin resistance. Lower gestational age and hyperglycaemia are associated with higher concentrations of insulin resistance markers.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024. Vol. 8, no 1, article id e002470
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Pediatrics
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URN: urn:nbn:se:umu:diva-220760DOI: 10.1136/bmjpo-2023-002470Scopus ID: 2-s2.0-85184815394OAI: oai:DiVA.org:umu-220760DiVA, id: diva2:1836867
Funder
Umeå UniversityRegion Västerbotten, RV-832421Region Västerbotten, RV-930256Samariten foundation for paediatric research, 2016-0221Samariten foundation for paediatric research, 2017-0275Samariten foundation for paediatric research, 2018-0450Available from: 2024-02-12 Created: 2024-02-12 Last updated: 2024-04-24Bibliographically approved

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Zamir, ItayStoltz Sjöström, Elisabethvan den Berg, JohannesNaumburg, EstelleDomellöf, Magnus

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Zamir, ItayStoltz Sjöström, Elisabethvan den Berg, JohannesNaumburg, EstelleDomellöf, Magnus
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