Abstract
Children born small (SGA) or large (LGA) for gestational age are prone to develop
insulin resistance (IR) during childhood. Visfatin, a hormone with insulin-mimetic
actions, has been associated with IR. This study was designed to examine whether serum
level of visfatin is correlated with metabolic indices of IR, in prepuberty in association
with the intrauterine growth pattern. The following parameters were evaluated at a
mean age of 6.5±1.2 years in 155 prepubertal children born appropriate for the gestational
age (AGA) (n=63), or SGA (n=42), or LGA (n=50): serum levels of visfatin, adiponectin,
leptin, fasting glucose (GF) and insulin (IF), the homeostasis model assessment IR index (HOMA-IR), plasma lipids, anthropometric
indices at birth and the time of evaluation, and obesity indices [waist circumference
(WC), body mass index (BMI) and skinfold thickness]. The mean serum level of visfatin
was lower in the SGA than in the AGA and the LGA children (9±5.2 vs. 11.8±5.1 and
12.7±5.6 ng/ml, respectively, p<0.01). Girls had lower visfatin levels than boys (10.4±4.3 ng/ml
vs. 12.5±6.7 ng/ml, p<0.05). Visfatin was not correlated with IR indices. In multiple
regression analysis visfatin level was positively correlated with birth weight z-score
(t=2.56, beta=0.24, p<0.01) and crown to heel z-score (t=2.46, beta=0.22, p=0.014), independent of age, gender, maternal weight before pregnancy,
maternal weight gain during pregnancy, BMI z-score, WC z-score, serum leptin and adiponectin,
and HOMA-IR. In conclusion serum visfatin level was lower in prepubertal SGA children
but not correlated with IR indices. Low birth weight was an independent predictor
of visfatin level.
Key words
visfatin - insulin resistance - fetal growth - obesity - birth weight
