Rapid growth in kids linked to high insulin, HOMA-IR

Rapid growth in children may lead to elevated insulin and homeostatic model assessment for insulin resistance (HOMA-IR), reports a recent meta-analysis.

Drawing from the databases of Embase, Medline, CNKI, and WANFANG, the researchers included 26 studies eligible for meta-analysis. Of these, 22 reported on the link between rapid growth and fasting blood insulin while 20 looked at the effect on HOMA-IR. All studies were observational in design and yielded a total of 2,151 participants.

Pooled analysis of 44 data points from 22 eligible studies showed that children with rapid growth had significantly higher fasting insulin than controls (pooled weighted mean difference [WMD], 5.544, 95 percent confidence interval [CI], 1.436–9.653; p=0.008).

Subgroup analysis revealed that such an effect was observed in participants followed up after 6 years of age (WMD, 7.789, 95 percent CI, 2.373–13.205; p=0.005) and those who had rapid growth duration <2 years (WMD, 8.908, 95 percent CI, 3.286–14.531; p=0.002).

Forty-two valid data were eligible for analysis in the 20 HOMA-IR studies. Cumulative findings showed that rapid growth was associated with higher HOMA-IR (WMD, 0.194, 95 percent CI, 0.098–0.290; p<0.001).

Subgroup analysis similarly revealed that such an effect was apparent in those followed up after 6 years of age (WMD, 0.340, 95 percent CI, 0.193–0.487; p<0.001). In contrast to fasting insulin, however, the impact on HOMA-IR was significant in participants with rapid growth duration >2 years (WMD, 0.200, 95 percent CI, 0.121–0.278; p<0.001).

“The present study confirms that rapid growth would result in high fasting insulin and HOMA-IR, especially for full-term infants,” the researchers said. “However, rapid growth may be harmless for subjects who were preterm, low birthweight, or small for gestational age, and may even benefit preterm infants.”

“Given that the burden of hyperglycaemia is rising globally, our findings have important implications for public health practice, especially considering that postnatal growth patterns are modifiable,” they added.