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

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          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)

                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                05 October 2001
                : 55
                : 4
                : 172-178
                a1st Department of Internal Medicine, b1st Department of Pediatrics, Semmelweis University, Joint Research Program of the Hungarian Academy of Sciences, Budapest, Hungary
                49991 Horm Res 2001;55:172–178
                © 2001 S. Karger AG, Basel

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


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