de Jong Miranda, Lafeber Harrie N, Cranendonk Anneke, van Weissenbruch Mirjam M
Department of Pediatrics, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Horm Res Paediatr. 2014;81(1):43-9. doi: 10.1159/000355597. Epub 2013 Nov 20.
BACKGROUND/AIMS: Term small-for-gestational-age and preterm born infants have an increased prevalence of metabolic syndrome components already in childhood. Data in very-low-birth-weight (VLBW) children are limited. We investigated the prevalence of metabolic syndrome components in VLBW infants at 2 years of corrected age.
We included 38 children, participating in the Neonatal Insulin Replacement Therapy in Europe (NIRTURE) trial, a randomized controlled trial of early insulin therapy in VLBW infants. Metabolic syndrome components were defined as: body mass index SDS >2; blood pressure (systolic and/or diastolic) ≥ 90th percentile; triglycerides ≥ 0.98 mmol/l; high-density lipoprotein (HDL) cholesterol ≤ 1.03 mmol/l; glucose ≥ 5.6 mmol/l.
Two children (5%) had three metabolic syndrome components, 13 children (34%) had two components, and 11 children (29%) one component. 63% had raised blood pressure (prevalence higher in boys), 32% low HDL, and 30% high triglycerides (prevalence lower in early insulin group). In children with body mass index SDS <0, insulin-treated children had higher HDL than children with standard care. Systolic blood pressure was correlated with growth between term and 2 years of corrected age.
VLBW infants already have a high prevalence of metabolic syndrome components at 2 years of corrected age. Early insulin treatment could have long-term benefits for some of these components.
背景/目的：足月小样儿和早产儿在儿童期代谢综合征各组分的患病率就已升高。极低出生体重（VLBW）儿童的数据有限。我们调查了校正年龄2岁的VLBW婴儿代谢综合征各组分的患病率。
我们纳入了38名儿童，他们参与了欧洲新生儿胰岛素替代疗法（NIRTURE）试验，这是一项关于VLBW婴儿早期胰岛素治疗的随机对照试验。代谢综合征各组分定义为：体重指数标准差评分>2；血压（收缩压和/或舒张压）≥第90百分位数；甘油三酯≥0.98 mmol/l；高密度脂蛋白（HDL）胆固醇≤1.03 mmol/l；血糖≥5.6 mmol/l。
2名儿童（5%）有三种代谢综合征组分，13名儿童（34%）有两种组分，11名儿童（29%）有一种组分。63%血压升高（男孩患病率更高），32%HDL降低，30%甘油三酯升高（早期胰岛素治疗组患病率更低）。在体重指数标准差评分<0的儿童中，接受胰岛素治疗的儿童HDL高于接受标准治疗的儿童。收缩压与足月至校正年龄2岁期间的生长相关。
校正年龄2岁时，VLBW婴儿代谢综合征各组分的患病率已很高。早期胰岛素治疗可能对其中一些组分有长期益处。
