Payal Vikas, Jora Rakesh, Sharma Pramod, Gupta Pradeep Kumar, Gupta Mukesh
Department of Pediatrics, Dr. S.N. Medical College, Umaid Hospital, Jodhpur, Rajasthan, India.
Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):497-505. doi: 10.4103/2230-8210.183470.
This study was done to determine the role of prematurity and other variables to predict insulin sensitivity in infancy.
In this prospective study, 36 preterm appropriate for gestational age (AGA), 11 preterm small for gestational age (SGA), and 17 term SGA included as study cohort and 36 term AGA as control cohort. Detailed anthropometry assessment was performed at birth, 3, 6, and 9 months and at 9 months, fasting plasma glucose and serum insulin was done. Insulin resistance was determined by using homeostasis model assessment version 2.
It is found that preterm AGA (mean difference 0.617, 95% confidence interval [CI]; 0.43-0.80, P = 0.0001), preterm SGA (mean difference 0.764, 95% CI; 0.44-1.09, P = 0.0001), and term AGA (mean difference 0.725, 95% CI; 0.49-0.96, P = 0.0001) group had significantly higher insulin resistance than control. There was no significant difference in between preterm SGA and preterm AGA (mean difference 0.147 95% CI; -0.13-0.42, P = 0.927). In multiple regression models, SGA status (β =0.505) was more significant predictor of insulin resistance index than gestational age (β = -0.481), weight-for-length (β =0.315), and ponderal index (β = -0.194).
Preterm birth is a risk factor for the future development of insulin resistance which may develop as early as infancy.
本研究旨在确定早产及其他变量在预测婴儿期胰岛素敏感性方面的作用。
在这项前瞻性研究中，36例适于胎龄（AGA）的早产儿、11例小于胎龄（SGA）的早产儿和17例足月SGA被纳入研究队列，36例足月AGA作为对照队列。在出生时、3个月、6个月、9个月进行详细的人体测量评估，并在9个月时检测空腹血糖和血清胰岛素。采用稳态模型评估版本2来确定胰岛素抵抗。
发现早产AGA组（平均差异0.617，95%置信区间[CI]：0.43 - 0.80，P = 0.0001）、早产SGA组（平均差异0.764，95% CI：0.44 - 1.09，P = 0.0001）和足月AGA组（平均差异0.725，95% CI：0.49 - 0.96，P = 0.0001）的胰岛素抵抗均显著高于对照组。早产SGA组和早产AGA组之间无显著差异（平均差异0.147，95% CI： - 0.13 - 0.42，P = 0.927）。在多元回归模型中，SGA状态（β = 0.505）比胎龄（β = - 0.481）、身长体重比（β = 0.315）和 ponderal指数（β = - 0.194）更能显著预测胰岛素抵抗指数。
早产是未来发生胰岛素抵抗的一个危险因素，这种情况可能早在婴儿期就会出现。
