小于胎龄儿出生后早期追赶生长与胰岛素敏感性关系分析

Postnatal early catch-up growth and insulin sensitivity in small for gestational age infants

【目的】旨在探讨小于胎龄(small for gestational age,SGA)儿生后早期的追赶生长与胰岛素敏感性关系。【方法】采用前瞻性研究方法,分析44名SGA儿与74名适于胎龄(appropriate for gestational age,AGA)儿3个月时的餐前血糖、胰岛素及内稳态模式评估(HOMA)值,以及SGA儿的追赶生长与上述指标的关系。【结果】SGA儿3月龄时餐前胰岛素及HOMA值均显著高于AGA儿;SGA儿追赶生长速度与胰岛素及HOMA值呈明显负相关(P<0.05)。在SGA儿中12名体重身长均为出现追赶生长者,其胰岛素水平和HOMA值均显著高于生后3 d[胰岛素(21.92±14.25)mU/L vs(11.08±9.59)mU/L,P<0.05;HOMA值(4.15±2.96)vs(1.86±1.71),P<0.05]。【结论】SGA儿生后早期的追赶生长与胰岛素敏感性密切相关,此时的生长迟缓很可能会导致胰岛素敏感性进一步降低。

【Objective】 To explore the relationship of postnatal catch-up growth and insulin sensitivity. 【Methods】 Fasting glucose,insulin and HOMA value in 44 small for gestational age（SGA） infants and 74 appropriate for gestational age（AGA） infants at age 3-month were studied by a prospective study,and the relations with catch-up growth were analyzed in 44 SGA infants. 【Results】 SGA infants had significantly higher fasting insulin concentration and HOMA value than did AGA infants.Adjustment for gestation,there was a negative association between velocity of catch-up growth and insulin concentration and HOMA value in SGA infants（P〈0.05）.12 non-catch-up growth in weight and length infants had significantly higher fasting insulin concentration and HOMA value than did they on the third day after birth in SGA group respectively [insulin：（21.92±14.25）mU/L vs（11.08±9.59）mU/L P〈0.05;HOMA：（4.15±2.96） vs（1.86±1.71）,P〈0.05]. 【Conclusions】 Catch-up growth is closely related with insulin sensitivity in early postnatal life,and poor growth might result in worse insulin sensitivity in SGA infants during that time.