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      Effect of Low Birth Weight on Adrenal Steroids and Carbohydrate Metabolism in Early Adulthood

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          Abstract

          Aim: Data are inconsistent whether hyperinsulinemia might be associated with adrenal hyperandrogenism in young adults born with low birth weight (LBW). Method: We investigated the insulin and adrenal steroid production of 70 young LBW adults [33 women (birth weight: 1,795 ± 435 g) and 37 men (birth weight: 1,832 ± 337 g)]. Their results were compared to those of 30 controls (14 men, 16 women), born with normal weight. Results: In LBW women, we measured higher basal DHEA (33.5 ± 13.1 vs. 23.6 ± 8.7 nmol/l, p < 0.05), DHEAS (8.0 ± 2.3 vs. 6.3 ± 2.1 µmol/l, p < 0.05), androstenedione (8.3 ± 2.8 vs. 6.0 ± 2.2 nmol/l, p < 0.05) and cortisol (0.25 ± 0.07 vs. 0.20 ± 0.07 µmol/l, p < 0.05) levels and higher insulin response during oral glucose tolerance test (log.AUCins: 2.62 ± 0.06 vs. 2.57 ± 0.03, p < 0.05). DHEA levels correlated with fasting insulin levels (r = 0.45, p < 0.01) and insulin response (r = 0.33, p < 0.05). In LBW men, higher cortisol (0.27 ± 0.06 vs. 0.22 ± 0.06 µmol/l, p < 0.01) and SHBG (18.4 ± 10.4 vs. 12.7 ± 5.9 nmol/l, p < 0.05) levels were found. Conclusions: Our results suggest that modest hypercortisolism is present in young LBW adults. While the endocrine sequel of hypercortisolism raised insulin response and hyperandrogenism is detectable in apparently healthy young LBW women, it is absent in young LBW men. This suggests that gender-dependent mechanisms might play a role in the development of insulin resistance in LBW adults.

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          Most cited references 8

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          Hyperinsulinemia as an independent risk factor for ischemic heart disease.

          Prospective studies suggest that hyperinsulinemia may be an important risk factor for ischemic heart disease. However, it has not been determined whether plasma insulin levels are independently related to ischemic heart disease after adjustment for other risk factors, including plasma lipoprotein levels. In 1985 we collected blood samples from 2103 men from suburbs of Quebec City, Canada, who were 45 to 76 years of age and who did not have ischemic heart disease. A first ischemic event (angina pectoris, acute myocardial infarction or death from coronary heart disease) occurred in 114 men (case patients) between 1985 and 1990. Each case patient was matched for age, body-mass index, smoking habits, and alcohol consumption with a control selected from among the 1989 men who remained free of ischemic heart disease during follow-up. After excluding men with diabetes, we compared fasting plasma insulin and lipoprotein concentrations at base line in 91 case patients and 105 controls. Fasting insulin concentrations at base line were 18 percent higher in the case patients than in the controls (P<0.001). Logistic-regression analysis showed that the insulin concentration remained associated with ischemic heart disease (odds ratio for ischemic heart disease with each increase of 1 SD in the insulin concentration, 1.7; 95 percent confidence interval, 1.3 to 2.4) after adjustment for systolic blood pressure, use of medications, and family history of ischemic heart disease. Further adjustment by multivariate analysis for plasma triglyceride, apolipoprotein B, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol concentrations did not significantly diminish the association between the insulin concentration and the risk of ischemic heart disease (odds ratio, 1.6; 95 percent confidence interval, 1.1 to 2.3). High fasting insulin concentrations appear to be an independent predictor of ischemic heart disease in men.
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            Adult cardiovascular risk factors in premature babies.

            Among babies born at term, low birthweight predicts cardiovascular risk factors and disease in adulthood. This study shows that babies born prematurely, whether or not they have intrauterine growth retardation, are predisposed to similar risks as adults.
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              Elevated Plasma Cortisol Concentrations: A Link between Low Birth Weight and the Insulin Resistance Syndrome?

               D Phillips (1998)
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                Author and article information

                Journal
                HRE
                Horm Res Paediatr
                10.1159/issn.1663-2818
                Hormone Research in Paediatrics
                S. Karger AG
                1663-2818
                1663-2826
                2001
                2001
                05 October 2001
                : 55
                : 4
                : 172-178
                Affiliations
                a1st Department of Internal Medicine, b1st Department of Pediatrics, Semmelweis University, Joint Research Program of the Hungarian Academy of Sciences, Budapest, Hungary
                Article
                49991 Horm Res 2001;55:172–178
                10.1159/000049991
                11598370
                © 2001 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 3, References: 32, Pages: 7
                Categories
                Original Paper

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