Scheurer J M, Gray H L, Demerath E W, Rao R, Ramel S E
Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
J Perinatol. 2016 Feb;36(2):145-50. doi: 10.1038/jp.2015.154. Epub 2015 Nov 5.
Characterize the relationship between neonatal hyperglycemia and growth and body composition at 4 months corrected age (CA) in very low birth weight (VLBW) preterm infants.
A prospective study of VLBW appropriate-for-gestation infants (N=53). All blood glucose measurements in the first 14 days and nutritional intake and illness markers until discharge were recorded. Standard anthropometrics and body composition via air displacement plethysmography were measured near term CA and 4 months CA. Relationships between hyperglycemia and anthropometrics and body composition were examined using multivariate linear regression.
Infants with >5 days of hyperglycemia were lighter (5345 vs 6455 g, P⩽0.001), shorter (57.9 vs 60.9 cm, P⩽0.01), had smaller occipital-frontal head circumference (39.4 vs 42.0 cm, P⩽0.05) and were leaner (percent body fat 15.0 vs 23.8, P⩽0.01) at 4 months CA than those who did not have hyperglycemia, including after correcting for nutritional and illness factors.
Neonatal hyperglycemia in VLBW infants is associated with decreased body size and lower adiposity at 4 months CA independent of nutritional deficit, insulin use and illness. Downregulation of the growth hormone axis may be responsible. These changes may influence long-term growth and cognitive development.
描述极低出生体重（VLBW）早产儿在矫正年龄（CA）4个月时新生儿高血糖与生长及身体成分之间的关系。
对VLBW适于胎龄儿（N = 53）进行的前瞻性研究。记录出生后前14天的所有血糖测量值以及直至出院时的营养摄入和疾病指标。在接近足月CA和4个月CA时测量标准人体测量学指标及通过空气置换体积描记法测量身体成分。使用多元线性回归研究高血糖与人体测量学指标和身体成分之间的关系。
高血糖持续超过5天的婴儿在4个月CA时比未发生高血糖的婴儿体重更轻（5345对6455 g，P≤0.001）、身高更矮（57.9对60.9 cm，P≤0.01）、枕额头围更小（39.4对42.0 cm，P≤0.05）且更瘦（体脂百分比15.0对23.8，P≤0.01），包括在校正营养和疾病因素后。
VLBW婴儿的新生儿高血糖与4个月CA时的体型减小和较低肥胖度相关，与营养缺乏、胰岛素使用和疾病无关。生长激素轴的下调可能是原因。这些变化可能影响长期生长和认知发育。
