Increased oxidative stress in prepubertal children born small for gestational age (SGA)

Context: Low birth weight is associated with an increased risk of metabolic and cardiovascular diseases in adulthood. The development of insulin resistance (IR) seems to play a pivotal role; no data on the oxidant-antioxidant status are available in this risk group. Objective: This study is an assessment of oxidant-antioxidant status in prepubertal children born small for gestational age (SGA) in comparison to healthy controls and the relationship to IR. Design: This cross-sectional study compares indexes of IR and oxidant-antioxidant status in three different groups (SGA!, SGA", controls), with analysis by post hoc and Pearson correlation. Setting: The study was conducted in the Academic Department of Pediatrics. Participants: A total of 19 SGA! and 16 SGA" children were compared with 13 controls. Intervention: No intervention was used. Main Outcome Measures: Indexes of IR (glucose to insulin ratio, homeostasis model assessment of IR) were evaluated, and markers of oxidative stress (lag phase, malonildialdehyde, vitamin E) were measured. Results: Homeostasis model assessment of IR was significantly higher in SGA! than SGA" children (1.32 # 0.9 vs. 0.69 # 0.47; P $ 0.03) and controls (0.71 # 0.37; P $ 0.04). Glucose to insulin ratio was significantly lower in SGA! than SGA" children (12.41 # 5.01 vs. 26.54 # 17.18; P $ 0.02) and controls (26.96 # 20.70; P $ 0.04). Lag phase was significantly shorter in SGA! than SGA" children (24.3 # 4.38 vs. 35.59 # 11.29 min; P $ 0.003) and controls (45.28 # 7.69 min; P $ 0.0001) and in SGA" than controls (P $ 0.01). Malonildialdehyde was significantly higher in SGA! than SGA" children (0.79 # 0.3 vs. 0.6 # 0.1 nmol/mg; P $ 0.03) and controls (0.36 # 0.04 nmol/mg; P $ 0.0001) and in SGA" children than controls (P $ 0.02). Vitamin E was significantly reduced in SGA! children than controls (27.54 # 7.9 vs. 43.23 # 11.32 !mol/liter; P $ 0.002). Conclusion: Oxidative stress is present in both SGA! and SGA" children, with a continuous alteration in relation to IR. Therefore, catch-up growth might exert the greatest influence in the development of future diseases.