High birth weight and early postnatal weight gain protect obese children and adolescents from truncal adiposity and insulin resistance: metabolically healthy but obese subjects?

Description

This cross-sectional study by Bouhours-Nouet et al. investigated the effect of high birth weight (HBW) and postnatal weight gain on insulin resistance in 117 obese children and adolescents (69 girls and 48 boys) aged 15 years. Study findings showed that subjects born with HBW had a lower central and higher peripheral fat distribution than those with a normal birth weight (eutrophic p<0.05), despite similar percentages of body fat mass. Moreover, adiponectin concentrations were significantly higher in HBW than in eutrophic subjects (p<0.05). The whole-body insulin sensitivity index and the hepatic insulin resistance index were respectively higher and lower in HBW compared to eutrophic (p<0.05) and low birth weight (LBW) subjects (p<0.05). Plasma insulin and free fatty acids were also significantly lower in HBW subjects than in eutrophic and LBW subjects (p<0.05). The authors also found that high weight gain between 0 and 2 years protected against future insulin resistance, whereas high weight gain after 4 years increased insulin resistance. These results suggest that HBW and early weight gain may program insulin sensitivity and adipose tissue metabolism and contribute to so-called metabolically healthy obesity.