Willemsen Ruben H, Leunissen Ralph W J, Stijnen Theo, Hokken-Koelega Anita C S
Department of Pediatrics, Division of Endocrinology, Erasmus Medical Centre Sophia, 3015 GJ Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 2009 May;94(5):1695-700. doi: 10.1210/jc.2008-1769. Epub 2009 Mar 3.
In 2005, 12.7% of all babies were born preterm, and the incidence is rising. Nowadays, due to improved survival, an increasing number of children born preterm reach young adulthood. A recent report suggested lower insulin sensitivity in children born preterm, which may put them at risk for the development of type 2 diabetes. It is, however, still unknown whether this reduced insulin sensitivity persists into adulthood.
We determined insulin sensitivity and beta-cell function with frequently sampled iv glucose tolerance tests in 305 young adults (aged 18-24 yr; 169 preterm and 136 term). Adult body composition was measured by dual energy x-ray absorptiometry. We investigated the effect of gestational age, size at birth, and adult body composition on insulin sensitivity.
In contrast to previous reports, we found no evidence that preterm birth has a deleterious effect on insulin sensitivity in young adulthood. Adult trunk fat and the use of oral contraceptives in women were the most important determinants of insulin insensitivity, independently of size at birth and duration of pregnancy.
Contrary to our hypothesis, preterm birth was not associated with reduced insulin sensitivity in young adulthood.
2005年，所有新生儿中12.7%为早产，且这一发生率正在上升。如今，由于存活率提高，越来越多的早产儿童步入青年期。最近一份报告显示，早产儿童的胰岛素敏感性较低，这可能使他们面临患2型糖尿病的风险。然而，这种降低的胰岛素敏感性是否会持续到成年期仍不清楚。
我们通过频繁采样静脉葡萄糖耐量试验，对305名青年（年龄18 - 24岁；169名早产和136名足月产）测定胰岛素敏感性和β细胞功能。采用双能X线吸收法测量成人身体组成。我们研究了胎龄、出生时大小和成人身体组成对胰岛素敏感性的影响。
与之前的报告相反，我们没有发现证据表明早产对青年期的胰岛素敏感性有有害影响。成人躯干脂肪以及女性使用口服避孕药是胰岛素不敏感的最重要决定因素，与出生时大小和孕期长短无关。
与我们的假设相反，早产与青年期胰岛素敏感性降低无关。
