Wang Xinli, Cui Yunpu, Tong Xiaomei, Ye Hongmao, Li Song
Department of Pediatrics, Peking University Third Hospital, Beijing 100083, People's Republic of China.
J Clin Endocrinol Metab. 2007 Feb;92(2):681-4. doi: 10.1210/jc.2006-1281. Epub 2006 Dec 5.
Reduced birth weight is associated with increased risk for the insulin resistance syndrome. Part of this risk is hypothesized to originate from intrauterine growth retardation.
The aim of this study is to determine whether or not the components of the insulin resistance syndrome are associated with reduced fetal growth.
This was a case-control study.
The study was conducted in Beijing, China.
Included in this study were 296 singleton neonates (177 males and 119 females), including 76 (37 preterm and 39 full-term newborns) classified as small for gestational age (SGA) and 220 who were appropriate for gestational age (AGA) (84 preterm and 136 full-term newborns).
The main outcome measures were postabsorptive glucose, insulin, and lipids levels on the third day after birth.
Both full-term and preterm SGA neonates had higher insulin concentrations (mean +/- SEM, 17.11 +/- 1.15 vs.6.80 +/- 0.62 microIU/ml in full-term, P < 0.01; 11.99 +/- 1.18 vs.8.37 +/- 0.78 microIU/ml in preterm, P = 0.03), insulin to glucose ratios (4.48 +/- 0.37 vs. 1.78 +/- 0.20 in full-term, P < 0.01; 3.28 +/- 0.38 vs. 2.30 +/- 0.26 in preterm, P = 0.03), triglycerides (2.29 +/- 0.23 vs.1.57 +/- 0.13 mmol/liter in full-term, P < 0.01; 2.27 +/- 0.16 vs. 1.34 +/- 0.11 mmol/liter in preterm, P < 0.01), total cholesterol (2.35 +/- 0.12 vs. 1.82 +/- 0.22 mmol/liter in full-term, P = 0.04; 2.57 +/- 0.22 vs. 1.95 +/- 0.15 mmol/liter in preterm, P = 0.02), and low-density lipoprotein cholesterol (2.11 +/- 0.58 vs. 1.24 +/- 0.61 mmol/liter in full-term, P = 0.01; 1.87 +/- 0.60 vs. 1.38 +/- 0.59 mmol/liter in preterm, P < 0.01) concentrations than did AGA neonates; however, they had similar glucose levels. Among AGA infants, insulin concentration, insulin to glucose ratios, and lipids levels did not significantly differ between full-term and preterm babies.
In this study, SGA neonates displayed profiles suggestive of lower insulin sensitivity and less favorable lipid metabolism in the early postnatal period.
出生体重降低与胰岛素抵抗综合征风险增加相关。部分风险被认为源于子宫内生长受限。
本研究旨在确定胰岛素抵抗综合征的各组成部分是否与胎儿生长受限有关。
这是一项病例对照研究。
该研究在中国北京进行。
本研究纳入了296名单胎新生儿（177名男性和119名女性），其中76名（37名早产儿和39名足月儿）被归类为小于胎龄儿（SGA），220名是适于胎龄儿（AGA）（84名早产儿和136名足月儿）。
主要观察指标为出生后第三天的空腹血糖、胰岛素和血脂水平。
足月和早产SGA新生儿的胰岛素浓度均较高（平均值±标准误，足月时为17.11±1.15 vs.6.80±0.62微国际单位/毫升，P<0.01；早产时为11.99±1.18 vs.8.37±0.78微国际单位/毫升，P = 0.03），胰岛素与葡萄糖比值（足月时为4.48±0.37 vs.1.78±0.20，P<0.01；早产时为3.28±0.38 vs.2.30±0.26，P = 0.03），甘油三酯（足月时为2.29±0.23 vs.1.57±0.13毫摩尔/升，P<0.01；早产时为2.27±0.16 vs.1.34±0.11毫摩尔/升，P<0.01），总胆固醇（足月时为2.35±0.12 vs.1.82±0.22毫摩尔/升，P = 0.04；早产时为2.57±0.22 vs.1.95±0.15毫摩尔/升，P = 0.02），以及低密度脂蛋白胆固醇（足月时为2.11±0.58 vs.1.24±0.61毫摩尔/升，P = 0.01；早产时为1.87±0.60 vs.1.38±0.59毫摩尔/升，P<0.01）浓度均高于AGA新生儿；然而，他们的血糖水平相似。在AGA婴儿中，足月和早产婴儿的胰岛素浓度、胰岛素与葡萄糖比值和血脂水平无显著差异。
在本研究中，SGA新生儿在出生后早期表现出胰岛素敏感性较低和脂质代谢较差的特征。
