Sato Ryosuke, Watanabe Hiroshi, Shirai Kenji, Ohki Shigeru, Genma Rieko, Morita Hiroshi, Inoue Eisuke, Takeuchi Masahiro, Maekawa Masato, Nakamura Hirotoshi
Department of Endocrinology and Metabolism, Division of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan.
BMJ Open. 2012 Feb 3;2(1):e000327. doi: 10.1136/bmjopen-2011-000327. Print 2012.
To investigate glucose regulation in young adults with very low birth weight (VLBW; <1500 g) in an Asian population.
Cross-sectional observational study.
A general hospital in Hamamatsu, Japan.
111 young adults (42 men and 69 women; aged 19-30 years) born with VLBW between 1980 and 1990. Participants underwent standard 75 g oral glucose tolerance test (OGTT).
The primary outcomes were glucose and insulin levels during OGTT and risk factors for a category of hyperglycaemia defined as follows: diabetes mellitus, impaired glucose tolerance (IGT), impaired fasting glycaemia (IFG) and non-diabetes/IGT/IFG with elevated 1 h glucose levels (>8.6 mmol/l). The secondary outcomes were the pancreatic β cell function (insulinogenic index and homeostasis model of assessment for beta cell (HOMA-β)) and insulin resistance (homeostasis model of assessment for insulin resistance (HOMA-IR)).
Of 111 young adults with VLBW, 21 subjects (19%) had hyperglycaemia: one had type 2 diabetes, six had IGT, one had IFG and 13 had non-diabetes/IGT/IFG with elevated 1 h glucose levels. In logistic regression analysis, male gender was an independent risk factor associated with hyperglycaemia (OR 3.34, 95% CI 1.08 to 10.3, p=0.036). Male subjects had significantly higher levels of glucose and lower levels of insulin during OGTT than female subjects (p<0.001 for glucose and p=0.005 for insulin by repeated measures analysis of variance). Pancreatic β cell function was lower in men (insulinogenic index: p=0.002; HOMA-β: p=0.001), although no gender difference was found in insulin resistance (HOMA-IR: p=0.477). In male subjects, logistic regression analysis showed that small for gestational age was an independent risk factor associated with hyperglycaemia (OR 33.3, 95% CI 1.67 to 662.6, p=0.022).
19% of individuals with VLBW already had hyperglycaemia in young adulthood, and male gender was a significant independent risk factor of hyperglycaemia. In male young adults with VLBW, small for gestational age was associated with hyperglycaemia.
在亚洲人群中研究极低出生体重（VLBW；<1500g）的年轻成年人的血糖调节情况。
横断面观察性研究。
日本滨松的一家综合医院。
1980年至1990年间出生的111名极低出生体重的年轻成年人（42名男性和69名女性；年龄19 - 30岁）。参与者接受了标准的75g口服葡萄糖耐量试验（OGTT）。
主要结局是OGTT期间的血糖和胰岛素水平，以及以下定义的一类高血糖的危险因素：糖尿病、糖耐量受损（IGT）、空腹血糖受损（IFG）以及1小时血糖水平升高（>8.6mmol/L）的非糖尿病/IGT/IFG。次要结局是胰腺β细胞功能（胰岛素生成指数和β细胞评估的稳态模型（HOMA-β））和胰岛素抵抗（胰岛素抵抗评估的稳态模型（HOMA-IR））。
在111名极低出生体重的年轻成年人中，21名受试者（19%）患有高血糖：1名患有2型糖尿病，6名患有IGT，1名患有IFG，13名患有1小时血糖水平升高的非糖尿病/IGT/IFG。在逻辑回归分析中，男性是与高血糖相关的独立危险因素（比值比3.34，95%置信区间1.08至10.3，p = 0.036）。在OGTT期间，男性受试者的血糖水平显著高于女性受试者，胰岛素水平低于女性受试者（重复测量方差分析，血糖p<0.001，胰岛素p = 0.005）。男性的胰腺β细胞功能较低（胰岛素生成指数：p = 0.002；HOMA-β：p = 0.001），尽管在胰岛素抵抗方面未发现性别差异（HOMA-IR：p = 0.477）。在男性受试者中，逻辑回归分析显示，小于胎龄是与高血糖相关的独立危险因素（比值比33.3，95%置信区间1.67至662.6，p = 0.022）。
19%的极低出生体重个体在年轻成年期已患有高血糖，男性是高血糖的重要独立危险因素。在极低出生体重的男性年轻成年人中，小于胎龄与高血糖有关。
