Hofman P L, Cutfield W S
Liggins Institute, University of Auckland, Auckland, New Zealand.
J Endocrinol Invest. 2006;29(1 Suppl):2-8.
Evidence has accumulated that small for gestational age (SGA) children have long-term adult health consequences including obesity, Type 2 diabetes mellitus, hypertension, coronary artery disease and stroke. This increased risk of later adult disease is likely a consequence of an early, persistent reduction in insulin sensitivity. The SGA children and adults studied were predominantly at term gestation, and it appears that prematurity also leads to insulin resistance with possibly similar health consequences for later life. Both term SGA and premature children have an abnormal early environment: one in utero and one post-natally. Parallels are made among those born SGA at term or premature to show the potential importance of maternal factors, the intrauterine milieu, including nutrient supply and intake in fetal and early newborn life. It is possible that manipulation of these factors during early neonatal life in premature babies could lead to normalisation of insulin sensitivity. To confirm this hypothesis, further studies are needed to better understand the pathophysiological mechanisms leading to reduced insulin sensitivity and confirm that prematurity is linked with similar long-term health consequences as being born SGA.
有证据表明，小于胎龄（SGA）儿童成年后会面临长期健康问题，包括肥胖、2型糖尿病、高血压、冠状动脉疾病和中风。成年后疾病风险增加可能是早期胰岛素敏感性持续下降的结果。所研究的SGA儿童和成人大多为足月出生，而且早产似乎也会导致胰岛素抵抗，对晚年健康可能产生类似影响。足月SGA儿童和早产儿童都有异常的早期环境：一个是子宫内环境，另一个是出生后环境。对足月或早产的SGA出生者进行了比较，以显示母体因素、子宫内环境（包括胎儿期和新生儿早期的营养供应和摄入）的潜在重要性。在早产儿出生后的早期生活中对这些因素进行干预，有可能使胰岛素敏感性恢复正常。为了证实这一假设，需要进一步研究，以更好地了解导致胰岛素敏感性降低的病理生理机制，并确认早产与出生时为SGA具有相似的长期健康后果。
