Decreased insulin sensitivity and abnormal glucose metabolism start in preadolescence in low-birth-weight children-Meta-analysis and systematic review

Abstract

Aims: Our meta-analysis aimed to analyze glucose and insulin abnormalities in small-for-gestational-age (SGA) or low-birth-weight (LBW) young people.

Methods: Our data were collected from several databases, including PubMed, AMED and so on. Cohort studies in English were included. SGA or LBW participants comprised the case group, while non-SGA or non-LBW participants comprised the control group. All subjects were younger than 45 years old.

Results: Sixteen studies and 10,060 subjects were included in this meta-analysis. The case group showed higher levels of oral glucose tolerance test (OGTT) 2-h glucose (mean difference (MD) = 0.32 mmol/L, 95% confidence interval (CI) 0.13-0.52 mmol/L, P = 0.0009) and fasting and OGTT 2-h insulin than the control group (respectively, MD = 7.47 pmol/L, 95% CI 1.77-13.17 pmol/L, P = 0.01 and MD = 105.55 pmol/L, 95% CI 65.43-145.66 pmol/L, P < 0.00001). In the preadolescence group (maximum age or 95% CI of age ≤10 years old), the OGTT 2-h glucose in the case group had an upward tendency compared to the control group, while the OGTT 2-h insulin in the case group was significantly higher than that in the control group (MD = 118.51 pmol/L, 95% CI 56.80-180.22 pmol/L, P = 0.0002). In the adolescence group (minimum age >10 years old and maximum age≤20 years old or 10 years old<95% CI of age≤20 years old), subjects in the case group showed significantly higher fasting and OGTT 2-h glucose than did the control group (respectively, MD = 0.14 mmol/L, 95% CI 0.04-0.24 mmol/L, P = 0.005 and MD = 0.40 mmol/L, 95% CI 0.08-0.71 mmol/L, P = 0.01). However, fasting and OGTT 2-h insulin in the case group were not significantly different from those in the control group (respectively, MD = 6.56 pmol/L, 95% CI -4.54-17.65 pmol/L, P = 0.25 and MD = 65.89 pmol/L, 95% CI -50.00-181.78 pmol/L, P = 0.27).

Conclusions: Decreased insulin sensitivity and abnormal glucose metabolism began early in preadolescence. Furthermore, glucose tolerance was worse in adolescence. LBW or SGA status affects glucose metabolism and insulin sensitivity beginning in preadolescence.

Keywords: Glucose metabolism; Insulin sensitivity; Low birth weight; Preadolescence; Small for gestational age.