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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
  1. Ryosuke Sato1,2,
  2. Hiroshi Watanabe3,
  3. Kenji Shirai4,
  4. Shigeru Ohki4,
  5. Rieko Genma2,
  6. Hiroshi Morita1,
  7. Eisuke Inoue5,
  8. Masahiro Takeuchi5,
  9. Masato Maekawa6,
  10. Hirotoshi Nakamura1
  1. 1Department of Endocrinology and Metabolism, Division of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan
  2. 2Department of Endocrinology and Metabolism, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
  3. 3Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
  4. 4Department of Neonatology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
  5. 5Department of Clinical Medicine (Biostatics), Kitasato University, Tokyo, Japan
  6. 6Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
  1. Correspondence to Dr Ryosuke Sato; ryos{at}hama-med.ac.jp

Abstract

Objectives To investigate glucose regulation in young adults with very low birth weight (VLBW; <1500 g) in an Asian population.

Design Cross-sectional observational study.

Setting A general hospital in Hamamatsu, Japan.

Participants 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).

Primary and secondary outcome measures 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 β cell function (insulinogenic index and homeostasis model of assessment for beta cell (HOMA-β)) and insulin resistance (homeostasis model of assessment for insulin resistance (HOMA-IR)).

Results 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 β cell function was lower in men (insulinogenic index: p=0.002; HOMA-β: 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).

Conclusions 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.

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Footnotes

  • To cite: Sato R, Watanabe H, Shirai K, et al. A cross-sectional study of glucose regulation in young adults with very low birth weight: impact of male gender on hyperglycaemia. BMJ Open 2012;2:e000327. doi:10.1136/bmjopen-2011-000327

  • Contributors RS and HW drafted the paper. RS conceived the study. RS and KS developed the idea. RS, HW, KS, SO, RG, MM and HN were involved in study design. RS and KS participated in data acquisition. RS, HW, HM, EI, MT and MM were engaged in data analysis. All the authors contributed to the interpretation of the findings. All the authors were involved in the revision and approved the final version.

  • Funding This study was partly supported by grants from the Japan Society for the Promotion of Science (21390180) and from the Ministry of Health, Labour and Welfare in Japan (H23-Cardiovascular disease and Diabetes-011).

  • Correction notice This article replaces a previously published version. The tables in figure 2 have been removed.

  • Competing interests None.

  • Ethical approval The study was approved by the ethical committee of Seirei Hamamatsu General Hospital. All participants provided written informed consent to participate in the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data will not be publically accessible. However, interested individuals may contact the authors.

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