Fukui R, Matsuzaki N, Fujita T, Kidoguchi K, Suehara N, Aono T
Department of Obstetrics, Osaka Medical Center, Japan.
Obstet Gynecol. 1995 Feb;85(2):242-9. doi: 10.1016/0029-7844(94)00345-E.
To examine endocrine states of mothers with normal 75-g oral glucose tolerance tests (GTTs) who gave birth to large for gestational age (LGA) neonates (group I) and to examine those neonates.
We examined plasma glucose levels and serum immunoreactive insulin responses after the 75-g oral GTT was given to group I mothers (N = 34), mothers with an abnormal oral GTT who gave birth to LGA neonates (group II, N = 21), and those with normal oral GTTs having appropriate for gestational age neonates (group III, N = 173). We also examined the infants, checking neonatal birth weight, levels of immunoreactive insulin and C-peptide immunoreactivity in cord sera at birth and the lowest blood sugar level after birth to see if a correlation existed between them.
Group I and II mothers showed higher titers in plasma glucose levels and remarkably enhanced ratios of 60- to 30-minute immunoreactive insulin values (immunoreactive insulin up-ratio) after load compared with those of group III mothers. Cord serum immunoreactive insulin and C-peptide immunoreactivity were significantly higher and the lowest blood sugar level was significantly reduced in group I and II neonates compared with those in group III. We observed a positive correlation between cord serum immunoreactive insulin, C-peptide immunoreactivity, and birth weight, but a negative correlation between cord serum immunoreactive insulin, birth weight, and the lowest blood sugar level in group I and II neonates (strongest tendency in group II), but not in group III neonates.
All of the abnormal carbohydrate metabolic responses in group I mothers and neonates may result in the promotion of growth in LGA fetuses similar to group II, but to a lesser extent. Identification of group I mothers by the immunoreactive insulin up-ratio after oral GTT will help predict the occurrence of LGA neonates and their possible hypoglycemia.
研究口服75克葡萄糖耐量试验（GTT）正常但分娩出大于胎龄（LGA）新生儿的母亲的内分泌状态，并对这些新生儿进行检查。
我们对三组母亲进行了口服75克GTT后血浆葡萄糖水平和血清免疫反应性胰岛素反应的检测，第一组母亲（N = 34）为口服GTT正常但分娩出LGA新生儿的母亲，第二组母亲（N = 21）为口服GTT异常且分娩出LGA新生儿的母亲，第三组母亲（N = 173）为口服GTT正常且分娩出适于胎龄新生儿的母亲。我们还对这些婴儿进行了检查，检测新生儿出生体重、出生时脐带血清中免疫反应性胰岛素和C肽免疫反应性水平以及出生后最低血糖水平，以观察它们之间是否存在相关性。
与第三组母亲相比，第一组和第二组母亲的血浆葡萄糖水平滴度更高，负荷后60至30分钟免疫反应性胰岛素值的比值（免疫反应性胰岛素上升比值）显著升高。与第三组相比，第一组和第二组新生儿脐带血清免疫反应性胰岛素和C肽免疫反应性显著更高，最低血糖水平显著降低。我们观察到第一组和第二组新生儿脐带血清免疫反应性胰岛素、C肽免疫反应性与出生体重之间呈正相关，但脐带血清免疫反应性胰岛素、出生体重与最低血糖水平之间呈负相关（第二组趋势最强），而第三组新生儿未观察到这种相关性。
第一组母亲和新生儿所有异常的碳水化合物代谢反应可能导致LGA胎儿生长加速，类似于第二组，但程度较轻。通过口服GTT后免疫反应性胰岛素上升比值识别第一组母亲将有助于预测LGA新生儿的发生及其可能的低血糖情况。
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