Abstract
Background
The impact of intrauterine and extrauterine growth on later insulin resistance and fat mass (FM) in very low birth weight (VLBW) infants is not well established. The aim of our study was to evaluate the effects of intrauterine and early/late extrauterine growth on later insulin resistance and body composition in VLBW infants from 6 months’ corrected age (CA) to 36 months.
Methods
Prospective measurements of body composition by dual-energy X-ray absorptiometry and insulin resistance by homeostasis model assessment insulin resistance (HOMA-IR) along with other fasting plasma biochemistries were made in 95 VLBW infants at 6, 12, 18, and 24 months’ CA and 36 months’ postnatal age. Mixed-effect models were used to evaluate the effects of age, sex, maturation status, and Δweight SD score on percentage FM (PFM), FM index (FMI), fat-free mass index (FFMI), and HOMA-IR.
Results
PFM and FMI were negatively associated with a decrease in weight–SD scores from birth to 36 weeks’ postmenstrual age (PMA; P=0.001) and from 36 weeks’ PMA to 6 months’ CA (P=0.003). PFM and FMI were higher in AGA than in small for gestational age (SGA) infants. HOMA-IR was not associated with the Δweight–SD scores in either period.
Conclusions
Catch-down growth in terms of weight is associated with persistently lower adiposity but not insulin resistance up to 36 months of age.
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This study was partially funded by the Fondo de Investigación Sanitaria and Fondos FEDER (Grants: PI041631 to M.S.P. and PI100747 and PI1302195 to J.A.).
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Saenz de Pipaon, M., Dorronsoro, I., Álvarez-Cuervo, L. et al. The impact of intrauterine and extrauterine weight gain in premature infants on later body composition. Pediatr Res 82, 658–664 (2017). https://doi.org/10.1038/pr.2017.123
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DOI: https://doi.org/10.1038/pr.2017.123
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