Hawdon J M, Aynsley-Green A, Alberti K G, Ward Platt M P
Department of Child Health, University of Newcastle upon Tyne.
Arch Dis Child. 1993 Mar;68(3 Spec No):274-9. doi: 10.1136/adc.68.3_spec_no.274.
The glucoregulatory role of insulin in adult subjects is undisputed. However, less is known about the secretion of insulin and its actions in the neonatal period, either for healthy subjects, or for those at risk of disordered blood glucose homoeostasis. The relationships between blood glucose and plasma immunoreactive insulin concentrations were therefore examined in 52 healthy children (aged 1 month-10 years), 67 appropriate birth weight for gestational age (AGA) term infants, and 39 AGA preterm neonates. In children and AGA neonates, plasma immunoreactive insulin concentration was positively related to blood glucose concentration. However, although both groups of neonates had significantly lower blood glucose concentrations than children, plasma immunoreactive insulin concentrations were significantly higher in both term and preterm neonates, when compared with children. The variation in plasma immunoreactive insulin concentrations was greater for neonates than for children. These data suggest, that compared with older subjects, plasma immunoreactive insulin concentrations are high in newborn babies and that neonatal pancreatic insulin secretion is less closely linked to circulating blood glucose concentrations. There are important implications for the interpretation of studies in hypoglycaemic and hyperglycaemic neonates.
胰岛素在成年个体中的血糖调节作用是无可争议的。然而，无论是对于健康受试者，还是对于有血糖稳态紊乱风险的受试者，胰岛素在新生儿期的分泌及其作用却鲜为人知。因此，研究人员对52名健康儿童（年龄1个月至10岁）、67名适于胎龄（AGA）足月儿和39名AGA早产儿的血糖与血浆免疫反应性胰岛素浓度之间的关系进行了研究。在儿童和AGA新生儿中，血浆免疫反应性胰岛素浓度与血糖浓度呈正相关。然而，尽管两组新生儿的血糖浓度均显著低于儿童，但与儿童相比，足月和早产新生儿的血浆免疫反应性胰岛素浓度均显著更高。新生儿血浆免疫反应性胰岛素浓度的变化比儿童更大。这些数据表明，与年长受试者相比，新生儿的血浆免疫反应性胰岛素浓度较高，且新生儿胰腺胰岛素分泌与循环血糖浓度的联系没那么紧密。这对于解读低血糖和高血糖新生儿的研究具有重要意义。
