Gohlke Bettina C, Stutte Sonja, Bartmann Peter, Woelfle Joachim
Department of Pediatrics, University of Bonn, Bonn, Germany.
J Pediatr Endocrinol Metab. 2009 Sep;22(9):827-35. doi: 10.1515/jpem.2009.22.9.827.
Increasing numbers of extremely low birth weight infants (ELBW, birth weight < 1,000 g) survive. We studied the impact of birth weight, gender, and catch-up growth on metabolic parameters in ELBW infants.
Sixty-three ELBW children were investigated at a mean age of 5.8 years. Forty-eight showed catch-up growth.
ELBW children who were small for gestational age were significantly shorter than those whose size was appropriate for their gestational age (height SDS: -1.1 [SD 0.8] vs -0.4 [0.9]; p < 0.001). This corresponded with significantly lower standard deviation scores for IGF-I (-1.1 [1.3] vs 0.1 [0.8]; p < 0.05) and IGFBP-3 (-0.7 [1.7] vs 0.4 [1.1]; p < 0.05). No differences were found regarding fasting insulin, glucose, HOMA and IGFBP-1. The catch-up group showed lower IGFBP-1 concentrations than the non-catch-up group. IGFBP-1 decreased in individuals who became more insulin resistant. No differences were found regarding mean IGF-1 and IGFBP-3 SDS. A gender-related pattern was found for weight development: girls demonstrated a normalization of BMI from the age of 2 years whereas boys remained at a mean BMI of -1.96 SDS. Corresponding to this, girls showed lower IGFBP-1 levels than boys.
Metabolic parameters in ELBW children are modulated by subsequent catch-up growth and sex-dependent weight development, resulting in measurable differences even in early childhood.
极低出生体重儿（ELBW，出生体重<1000g）存活数量不断增加。我们研究了出生体重、性别和追赶生长对ELBW婴儿代谢参数的影响。
对63名ELBW儿童进行了调查，平均年龄为5.8岁。其中48名儿童出现了追赶生长。
小于胎龄的ELBW儿童明显比出生体重与胎龄相称的儿童矮（身高标准差评分：-1.1[标准差0.8]对-0.4[0.9]；p<0.001）。这与IGF-I（-1.1[1.3]对0.1[0.8]；p<0.05）和IGFBP-3（-0.7[1.7]对0.4[1.1]；p<0.05）的标准差评分显著降低相对应。在空腹胰岛素、血糖、HOMA和IGFBP-1方面未发现差异。追赶生长组的IGFBP-1浓度低于非追赶生长组。个体胰岛素抵抗增强时IGFBP-1降低。在平均IGF-1和IGFBP-3标准差评分方面未发现差异。在体重发育方面发现了与性别相关的模式：女孩从2岁起BMI恢复正常，而男孩的平均BMI仍为-1.96标准差评分。与此相应，女孩的IGFBP-1水平低于男孩。
ELBW儿童的代谢参数受随后的追赶生长和性别依赖性体重发育的调节，即使在幼儿期也会导致可测量的差异。
