Pediatric Division, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Complejo Asistencial Dr. Sótero del Río, Puente Alto, Santiago, Chile.
Endocrinol Diabetes Metab. 2022 May;5(3):e00329. doi: 10.1002/edm2.329. Epub 2022 Feb 23.
Preterm neonates are at risk for metabolic syndrome later in life. Whether prematurity constitutes an independent risk factor for the development of cardiovascular disease and metabolic syndrome remains controversial.
To compare anthropometric measures, cardiometabolic risk factors and insulin resistance variables between children who were born very preterm (VPT, <32 gestational weeks) and at term (Term, >37 gestational weeks) and adequate for gestational age (AGA).
We designed a cross-sectional cohort study, recruiting 120 children (5.0-8.5 years old) from the preterm clinic at Red de Salud UC-Christus and Complejo Asistencial Dr. Sótero del Río, and term children from the community. We excluded children born small for gestational age, based on INTERGROWTH21. Anthropometrics data were classified using WHO reference standards. The homeostasis model assessment insulin resistance (HOMA-IR) index, quantitative insulin sensitivity check index (QUICKI), triglyceride-to-HDL-C ratio (TG/HDL-C) and Pediatric Score Index for Metabolic Syndrome (PsiMS) were calculated.
VPT children born AGA had lower HDL cholesterol levels (p = .019) and a higher PsiMS score than those born at term (p = .043). We observed a higher percentage of children with HDL cholesterol ≤40 mg/dl (13.0% vs. 2.3%, p = .026) and BP ≥90th percentile among the VPT children than among the Term children (26.0% vs. 11.6%, p = .031).
At school age, blood pressure was higher, and HDL-C was lower among VPT children born AGA, suggesting a potential metabolic risk; therefore, it is essential to follow this group throughout their lives.
早产儿在以后的生活中存在代谢综合征的风险。早产儿是否构成心血管疾病和代谢综合征发展的独立危险因素仍存在争议。
比较出生极低体重儿（VPT，<32 孕周）和足月（Term，>37 孕周）且适于胎龄儿（AGA）的儿童的人体测量指标、心血管代谢危险因素和胰岛素抵抗变量。
我们设计了一项横断面队列研究，招募了来自 Red de Salud UC-Christus 和 Complejo Asistencial Dr. Sótero del Río 早产儿诊所的 120 名（5.0-8.5 岁）和社区足月儿童。我们根据 INTERGROWTH21 排除了出生小于胎龄儿。使用 WHO 参考标准对人体测量数据进行分类。计算了稳态模型评估的胰岛素抵抗指数（HOMA-IR）、定量胰岛素敏感性检测指数（QUICKI）、甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）和儿童代谢综合征评分指数（PsiMS）。
VPT 出生的 AGA 儿童的 HDL 胆固醇水平较低（p = 0.019），PsiMS 评分高于 Term 出生的儿童（p = 0.043）。我们观察到 VPT 儿童中 HDL 胆固醇≤40mg/dl 的比例较高（13.0% vs. 2.3%，p = 0.026）和血压≥90 百分位的比例较高（26.0% vs. 11.6%，p = 0.031）。
在学龄期，VPT 出生的 AGA 儿童的血压较高，HDL-C 较低，提示存在潜在的代谢风险；因此，有必要对这一组儿童进行终生随访。
