Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Pediatr Res. 2023 Sep;94(3):892-903. doi: 10.1038/s41390-023-02628-9. Epub 2023 Apr 29.
Hyperglycemia is commonly encountered in extremely preterm newborns and physiologically can be attributed to immaturity in several biochemical pathways related to glucose metabolism. Although hyperglycemia is associated with a variety of adverse outcomes frequently described in this population, evidence for causality is lacking. Variations in definitions and treatment approaches have further complicated the understanding and implications of hyperglycemia on the immediate and long-term effects in preterm newborns. In this review, we describe the relationship between hyperglycemia and organ development, outcomes, treatment options, and potential gaps in knowledge that need further research. IMPACT: Hyperglycemia is common and less well described than hypoglycemia in extremely preterm newborns. Hyperglycemia can be attributed to immaturity in several cellular pathways involved in glucose metabolism in this age group. Hyperglycemia has been shown to be associated with a variety of adverse outcomes frequently described in this population; however, evidence for causality is lacking. Variations in definitions and treatment approaches have complicated the understanding and the implications of hyperglycemia on the immediate and long-term effects outcomes. This review describes the relationship between hyperglycemia and organ development, outcomes, treatment options, and potential gaps in knowledge that need further research.
高血糖在极早产儿中很常见,从生理学角度来看,这可归因于与葡萄糖代谢相关的几种生化途径不成熟。尽管高血糖与该人群中经常描述的各种不良结局相关,但缺乏因果关系的证据。定义和治疗方法的差异进一步增加了人们对高血糖对早产儿近期和长期影响的理解和意义的复杂性。在这篇综述中,我们描述了高血糖与器官发育、结局、治疗选择以及需要进一步研究的潜在知识差距之间的关系。 意义:高血糖在极早产儿中比低血糖更为常见,但描述得较少。高血糖可归因于该年龄段中涉及葡萄糖代谢的几个细胞途径不成熟。高血糖已被证明与该人群中经常描述的各种不良结局相关;然而,缺乏因果关系的证据。定义和治疗方法的差异使人们对高血糖对近期和长期结局的影响的理解和意义变得复杂。本综述描述了高血糖与器官发育、结局、治疗选择以及需要进一步研究的潜在知识差距之间的关系。