Ghirri Paolo, Ladaki Christini, Bartoli Ambra, Scirè Giuseppe, Vuerich Marco, Spadoni Gian Luigi, Maiorana Arianna, Geremia Caterina, Boldrini Antonio, Cianfarani Stefano
Division of Neonatology, S. Chiara Hospital, University of Pisa, Pisa, Italy.
Horm Res. 2007;67(3):123-31. doi: 10.1159/000096582. Epub 2006 Oct 25.
BACKGROUND/AIMS: Our aim was to investigate glucose homeostasis, insulin sensitivity and insulin-like growth factor (IGF) system status in children born small for gestational age (SGA).
A case-control study was carried out at birth, infancy and childhood, comparing SGA with children appropriate for gestational age strictly matched for age, gender, pubertal status and body mass index. Ninety newborns, 52 infants, and 68 children were studied. Fasting insulin (I(F)), fasting glucose (G(F)) to I(F) ratio (G(F)/I(F)), the homeostasis model assessment of insulin sensitivity, the quantitative insulin sensitivity check index, insulinogenic index and the triglyceride/high-density lipoprotein-cholesterol ratio were measured. IGF-I, IGF-binding protein-3 and the IGF-I/IGF-binding protein-3 molar ratio were assessed.
Glucose concentrations were lower in SGA newborns (p < 0.0001), infants (p = 0.01), and children (p = 0.001). Birth weight correlated with glucose levels at birth (r = 0.59, p < 0.0001), 12 months (r = 0.29, p = 0.04) and childhood (r = 0.44, p < 0.0001).
Our results provide evidence for a developmental adaptation of glucose metabolism in SGA children leading to reduced glucose concentrations.
背景/目的：我们的目的是研究小于胎龄儿（SGA）出生儿童的葡萄糖稳态、胰岛素敏感性和胰岛素样生长因子（IGF）系统状态。
在出生、婴儿期和儿童期进行了一项病例对照研究，将SGA儿童与年龄、性别、青春期状态和体重指数严格匹配的适于胎龄儿进行比较。研究了90名新生儿、52名婴儿和68名儿童。测量了空腹胰岛素（I(F)）、空腹血糖（G(F)）与I(F)的比值（G(F)/I(F)）、胰岛素敏感性的稳态模型评估、定量胰岛素敏感性检查指数、胰岛素生成指数和甘油三酯/高密度脂蛋白胆固醇比值。评估了IGF-I、IGF结合蛋白-3和IGF-I/IGF结合蛋白-3摩尔比。
SGA新生儿（p < 0.0001）、婴儿（p = 0.01）和儿童（p = 0.001）的血糖浓度较低。出生体重与出生时（r = 0.59，p < 0.0001）、12个月时（r = 0.29，p = 0.04）和儿童期（r = 0.44，p < 0.0001）的血糖水平相关。
我们的结果为SGA儿童葡萄糖代谢的发育适应性提供了证据，导致血糖浓度降低。
