宫内发育迟缓与新生儿胰岛素敏感性变化的相关性

Correlation between intrauterine growth retardation and changes of neonatal insulin sensitivity

目的:探讨宫内发育迟缓(IUGR)与新生儿胰岛素敏感性变化的关系。方法:2007年4～12月宁夏医学院附属医院新生儿科、产科对68例小于胎龄儿(SGA,病例组)和68例适于胎龄儿(AGA,对照组)生后48～72h空腹血糖(FPG)、空腹胰岛素(FINS)、C-肽、HDL-C、LDL-C、TG等指标进行检测,计算葡萄糖/胰岛素比值(G/I)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能(HBCI),分析宫内发育迟缓与新生儿胰岛素敏感性变化的相关性。结果:①SGA组FPG、HDL-C低于AGA组,而FINS、LDL-C、TG高于AGA组(P<0.01);②SGA组G/I比值、ISI低于AGA组,HOMA-IR高于AGA组(P<0.01),两组相比差异有统计学意义(P<0.05),两组间HBCI比较差异无统计学意义(P>0.05)。结论:宫内发育迟缓在生命早期存在胰岛素敏感性降低和不同程度的胰岛素抵抗(IR),而胰岛β细胞功能无明显变化。

Objective： To explore the relationship between intrauterine growth retardation and changes of neonatal insulin sensitivity. Methods： From April to December 2007, 68 neonates with small for gestational age （SGA） （study group） and 68 neonates with appropriate for gestational age （AGA） （control group） were selected. Fasting plasma glucose （FPG） , fasting insulin （FINS） , C -peptide, high density lipoprotein - cholesterol （ HDL - C）, low density lipoprotein - cholesterol （ LDL - C） and triglyceride （TG） of the neonates were detected, glucose/insulin ratio （G/I） , insulin sensitivity index （ISI）, insulin resistance index （HOMA -IR） and the function of β-cell of pancreatic islands （HCBI） were calculated, the relationship between intrauterine growth retardation and changes of neonatal insulin sensitivity was explored. Results： ①The levels of FPG and HDL - C in SGA group were lower than those in AGA group, but the levels of FINS, LDL - C and TG were higher than those in AGA group （ P 〈 0. 01 ） . ②G/I ratio and ISI in SGA group were lower than those in AGA group, HOMA- IR was higher than that in AGA group （P 〈 0.01 ） . There was no significant difference in HBCI between the two groups. Conclusion： In early postnatal life, neonates with intrauterine growth retardation display decreased insulin sensitivity and insulin resistance （IR） to some extent, however, the function of β-cell of pancreatic islands has no remarkable changes.