Oral or Poster Presentation
Concurrent Session 1C - DOHaD
Introduction: Fetal overgrowth, as indicated by being large-for-gestational age (LGA), has been associated with lower insulin sensitivity and beta cell function at birth. However, it is unclear whether these metabolic alternations persist into infancy or early childhood. This study aimed to determine whether LGA is associated with insulin sensitivity and β-cell function at age 2 years.
Methods: In the 3D (design, develop and discover) birth cohort in Canada, we studied 70 LGA (birth weight >90th percentile) and 140 optimal birth weight (OGA, 25th-75th percentiles) children of 2 years matched by maternal ethnicity, smoking status and gestational age at delivery. Plasma glucose-to-insulin ratio was used as an indicator of insulin sensitivity, and proinsulin-to-insulin ratio as an indicator of β-cell function. Plasma leptin and high-molecule-weight (HMW) adiponectin were also measured as biomarkers for metabolic status.
Results: Adjusted for maternal and infant characteristics, LGA had significantly higher cord blood insulin, proinsulin and leptin concentrations than OGA infants. LGA group also exhibited lower glucose-to-insulin ratios (all p<0.001), whereas its proinsulin-to-insulin ratio tended to be higher (p=0.07). However, all these differences disappeared in LGA vs. OGA infants at age 2 (all p>0.5). There were similar fasting plasma glucose-to-insulin ratios (LGA (median [IQR]: 22.1 [16.3-30.7]) vs. OGA (24.2 [16.7-36.0], p=0.69) as well as proinsulin-to-insulin ratios (LGA: 0.75 [0.23-1.40] vs OGA: 0.65 [0.26-1.93], p=0.71).
Conclusion: Insulin sensitivity and β cell function were similar in LGA vs OGA infants at age 2 years. This is the first study showing that LGA infants appear to have completely recovered from early life metabolic disturbances in infancy.