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早产合并宫外生长受限增加青春期前儿童血糖水平升高、低度炎症和高血压的风险。

Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children.

作者信息

Ordóñez-Díaz Maria D, Pérez-Navero Juan L, Flores-Rojas Katherine, Olza-Meneses Josune, Muñoz-Villanueva Maria C, Aguilera-García Concepción M, Gil-Campos Mercedes

机构信息

Department of Paediatrics, Maimónides Biomedical Research Institute, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain.

Centre for Biomedical Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain.

出版信息

Front Pediatr. 2020 Apr 21;8:180. doi: 10.3389/fped.2020.00180. eCollection 2020.

Abstract

An adipose tissue programming mechanism could be implicated in the extrauterine growth restriction (EUGR) of very preterm infants with morbidity in the cardiometabolic status later in life, as has been reported in intrauterine growth restriction. The aim of this study was to assess whether children with a history of prematurity and EUGR, but also with an adequate growth, showed alterations in the metabolic and inflammatory status. This was a case-control study. A total of 88 prepubertal children with prematurity antecedents were selected: 38 with EUGR and 50 with an adequate growth pattern (PREM group). They were compared with 123 healthy children born at term. Anthropometry, metabolic parameters, blood pressure (BP), C-reactive protein, hepatocyte growth factor (HGF), interleukin-6 (IL-6), IL-8, monocyte chemotactic protein type 1 (MCP-1), neural growth factor, tumour necrosis factor-alpha (TNF-α) and plasminogen activator inhibitor type-1 were analysed at the prepubertal age. EUGR children exhibited higher BP levels and a higher prevalence of hypertension (46%) compared with both PREM (10%) and control (2.5%) groups. Moreover, there was a positive relationship between BP levels and values for glucose, insulin and HOMA-IR only in children with a EUGR history. The EUGR group showed higher concentrations of most of the cytokines analysed, markedly higher TNF-α, HGF and MCP-1 levels compared with the other two groups. EUGR status leads to cardiometabolic changes and a low-grade inflammatory status in children with a history of prematurity, and that could be related with cardiovascular risk later in life.

摘要

正如宫内生长受限的情况一样,一种脂肪组织编程机制可能与极早产儿宫外生长受限(EUGR)有关,且这些早产儿日后存在心血管代谢疾病发病风险。本研究的目的是评估有早产和EUGR病史,但生长发育正常的儿童,其代谢和炎症状态是否有改变。这是一项病例对照研究。总共选取了88名有早产史的青春期前儿童:38名患有EUGR,50名生长发育正常(早产组)。将他们与123名足月出生的健康儿童进行比较。在青春期前对他们进行人体测量、代谢参数、血压(BP)、C反应蛋白、肝细胞生长因子(HGF)、白细胞介素-6(IL-6)、IL-8、单核细胞趋化蛋白-1(MCP-1)、神经生长因子、肿瘤坏死因子-α(TNF-α)和纤溶酶原激活物抑制剂-1进行分析。与早产组(10%)和对照组(2.5%)相比,EUGR儿童的血压水平更高,高血压患病率更高(46%)。此外,仅在有EUGR病史的儿童中,血压水平与血糖、胰岛素和HOMA-IR值之间存在正相关。与其他两组相比,EUGR组所分析的大多数细胞因子浓度更高,TNF-α、HGF和MCP-1水平明显更高。EUGR状态会导致有早产史的儿童出现心血管代谢变化和低度炎症状态,这可能与日后的心血管风险有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77a8/7186313/8d28adf2c491/fped-08-00180-g0001.jpg

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