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A cross-sectional study of glucose regulation in young adults with very low birth weight: impact of male gender on hyperglycaemia.

ABSTRACT: To investigate glucose regulation in young adults with very low birth weight (VLBW; <1500 g) in an Asian population.Cross-sectional observational study.A general hospital in Hamamatsu, Japan.111 young adults (42 men and 69 women; aged 19-30 years) born with VLBW between 1980 and 1990. Participants underwent standard 75 g oral glucose tolerance test (OGTT).The primary outcomes were glucose and insulin levels during OGTT and risk factors for a category of hyperglycaemia defined as follows: diabetes mellitus, impaired glucose tolerance (IGT), impaired fasting glycaemia (IFG) and non-diabetes/IGT/IFG with elevated 1 h glucose levels (>8.6 mmol/l). The secondary outcomes were the pancreatic ? cell function (insulinogenic index and homeostasis model of assessment for beta cell (HOMA-?)) and insulin resistance (homeostasis model of assessment for insulin resistance (HOMA-IR)).Of 111 young adults with VLBW, 21 subjects (19%) had hyperglycaemia: one had type 2 diabetes, six had IGT, one had IFG and 13 had non-diabetes/IGT/IFG with elevated 1 h glucose levels. In logistic regression analysis, male gender was an independent risk factor associated with hyperglycaemia (OR 3.34, 95% CI 1.08 to 10.3, p=0.036). Male subjects had significantly higher levels of glucose and lower levels of insulin during OGTT than female subjects (p<0.001 for glucose and p=0.005 for insulin by repeated measures analysis of variance). Pancreatic ? cell function was lower in men (insulinogenic index: p=0.002; HOMA-?: p=0.001), although no gender difference was found in insulin resistance (HOMA-IR: p=0.477). In male subjects, logistic regression analysis showed that small for gestational age was an independent risk factor associated with hyperglycaemia (OR 33.3, 95% CI 1.67 to 662.6, p=0.022).19% of individuals with VLBW already had hyperglycaemia in young adulthood, and male gender was a significant independent risk factor of hyperglycaemia. In male young adults with VLBW, small for gestational age was associated with hyperglycaemia.

SUBMITTER: Sato R

PROVIDER: S-EPMC3274711 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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A cross-sectional study of glucose regulation in young adults with very low birth weight: impact of male gender on hyperglycaemia.

Sato Ryosuke R Watanabe Hiroshi H Shirai Kenji K Ohki Shigeru S Genma Rieko R Morita Hiroshi H Inoue Eisuke E Takeuchi Masahiro M Maekawa Masato M Nakamura Hirotoshi H

BMJ open 20120203 1

<h4>Objectives</h4>To investigate glucose regulation in young adults with very low birth weight (VLBW; <1500 g) in an Asian population.<h4>Design</h4>Cross-sectional observational study.<h4>Setting</h4>A general hospital in Hamamatsu, Japan.<h4>Participants</h4>111 young adults (42 men and 69 women; aged 19-30 years) born with VLBW between 1980 and 1990. Participants underwent standard 75 g oral glucose tolerance test (OGTT).<h4>Primary and secondary outcome measures</h4>The primary outcomes wer ...[more]

PMID: 22307095

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Project description:ImportanceContradictory differences regarding fertility among adults born very preterm (VP; <32 weeks' gestation) or with very low birth weight (VLBW; <1500 g) have been reported at different ages. Longitudinal investigations of fertility beyond ages 20 to 29 years are lacking.ObjectiveTo assess whether VP and VLBW are associated with lower fertility up to age 35 years.Design, setting, and participantsThis prospective population-based cohort study was conducted in Bavaria, Germany, with participants born between January 1985 and March 1986 who required admission to a children's hospital within the first 10 days after birth. Healthy infants born at term (ie, at least 37 weeks' gestation) in the same hospital and children alive at 6 years were selected as controls. Follow-up occurred repeatedly up to 34 to 35 years. Data were analyzed from July to December 2024.ExposuresGestational age and birth weight.Main outcomes and measuresCumulative incidence of having the first alive child (ie, fertility) was calculated using Kaplan-Meier estimation and the difference between participants born VP or with VLBW and term-born participants was compared with log-rank tests. Univariable and hierarchical multivariable Cox proportional hazards regressions were performed to estimate hazard ratios (HRs) for fertility associated with VP and VLBW adjusting for individual factors. Estimations were compared between early (<30 years) and late (≥30 years) reproductive windows.ResultsA total of 414 participants (212 born VP or with VLBW and 202 term-born) were included (mean [SD] age, 34.67 [0.53] years; 216 [52.2%] female). Cumulative incidence of having the first alive child was lower in participants born VP or with VLBW throughout the follow-up. The association of VP and VLBW with lower fertility was significant during the late (HR, 0.46; 95% CI, 0.31-0.68) but not early (HR, 0.73; 95% CI, 0.47-1.14) reproductive window; this association attenuated after adjusting for neonatal factors (sex and family socioeconomic status) and childhood neurosensory impairment at step 2 (HR, 0.59; 95% CI 0.40-0.88), childhood family factors (eg, parenting) at step 3 (HR, 0.61; 95% CI, 0.40-0.92), and there was no longer an association after adjusting for sociodemographic factors (eg, partnering) at step 4 (HR, 0.78; 95% CI, 0.50-1.20). Partnering (ie, being married or cohabitating with a partner) had the largest magnitude association with fertility across both the early (HR, 7.87; 95% CI, 3.44-18.00) and late (HR, 3.95; 95% CI, 2.47-6.31) reproductive windows.Conclusions and relevanceIn this cohort study of participants born VP or with VLBW and term-born adults, VP and VLBW were associated with overall lower fertility. A major reason was an association of less partnering with lower fertility, suggesting that partnering is key to reproductive success.

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A cross-sectional study of glucose regulation in young adults with very low birth weight: impact of male gender on hyperglycaemia.

Publications

A cross-sectional study of glucose regulation in young adults with very low birth weight: impact of male gender on hyperglycaemia.

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