Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

GROWTH, INSULIN SENSITIVITY AND BODY COMPOSITION IN 12 YEAR OLD CHILDREN BORN PRETERM

Author

Korada SM

Institution

Royal Victoria Infirmary

Abstract

Objectives: To examine the growth patterns from birth to 12 years and to study the correlation between growth patterns, body composition and insulin sensitivity in adolescent children who were born preterm.

Methods: 153 children (9-13 yrs old) who were born preterm (=34 weeks gestation and = 1750 grams birth weight) who had originally been recruited to controlled trials of a nutritional intervention during infancy were studied. They had detailed auxological assessment and body compositional assessment using Dual Energy X-ray Absorptiometry (DEXA) scan and Bio-electrical impedance analysis (BIA). After an overnight fast (> 8hrs), fasting blood glucose and insulin and 30 minute samples after an oral glucose load were taken for assessment of Insulin sensitivity assessed using the homeostasis model assessment (HOMA) software. Auxological parameters and body compositional variables were examined against insulin sensitivity at 12 years. Statistical analysis was performed using STATA v11 and SPSS v15.

Results: Significant catch-up growth was observed in children born preterm so that by 12 years of age, their height and weight was comparable to population mean (1990 UK standards). Whilst insulin sensitivity at 12 years of age did not show a direct association with birth weight or gestational age, there was a positive association with change in weight SDS from birth to discharge and a negative association with change in weight from 2- 12 years age. Girls were less insulin sensitive at 12 years and also had higher fat mass index than boys. When step-wise regression analysis using key birth variables and current body composition variables was performed against insulin sensitivity, only current age and fat mass index remained significant.

Conclusion: Preterm born children show significant catch-up growth during childhood. While contemporary measures of body composition and current age show a strong association with insulin sensitivity at 12 years, early growth patterns also seem to be important. This suggests that there is some relationship between early life programming and its effects in adolescence even if it is a small one.