孕期糖代谢状况对早产儿早期胰岛功能的影响

Maternal glucose-insulin metabolism on early pancreatic islet function in premature infant

目的分析母亲孕期糖代谢状况对其早产儿早期胰岛功能的影响,并探讨监测早产儿早期胰岛功能的敏感指标。方法将2012年3月至12月入住新生儿重症监护病房的82例早产儿分为2组,母亲孕期糖代谢异常组(35例)和母亲孕期糖代谢正常组(47例),分别检测早产儿生后1 h和7 d的空腹血糖(FPG)、胰岛素(FINS)、C-肽和胰岛素原,并比较早产儿胰岛β细胞功能的相关指数。结果两组早产儿母亲的孕前和产前体质指数(BMI)、早产儿出生时体质量和头围的差异均有统计学意义(P<0.05),但母亲孕体质量期增加的差异无统计学意义(P>0.05)。两组早产儿出生时胰岛素原与生后7 d的C-肽、胰岛素原的差异有统计学意义(P<0.05)。两组早产儿胰岛素抵抗指数(IR)、空腹β细胞功能指数(FBCI)和胰岛素敏感指数(IAI)的差异无统计学意义(P>0.05)。结论母亲孕期糖代谢异常并不影响早产儿早期胰岛功能,但早产儿早期胰岛素原的分泌已受影响。

Objectives To analyze the impact of glucose-insulin metabolism during pregnancy on β-cell function in premature infant,and to explore biomarkers for monitoring β-cell function in preterm infant.Methods Eighty-two premature infants admitted to NICU from March to December 2012 were divided into 2 groups,a group with abnormal maternal glucose metabolism during pregnancy（35 cases） and another group with normal maternal glucose metabolism during pregnancy group（47 cases）.Fasting blood glucose,insulin,C-peptide and proinsulin at 1 hour after birth and 7 days postpartum were measured respectively,and relevant indices of β-cell function were compared in premature infants.Results Maternal pre-pregnancy and prenatal body mass index,weight and head circumference of preterm infants at birth were significantly different between two groups（P＆lt;0.05） except for maternal weight gain in pregnancy（P＆gt;0.05）.The differences in levels of proinsulin at birth,C-peptide and proinsulin at postnatal day 7 were significantly different between the two groups（P＆lt;0.05）.There was no significant difference in insulin resistance,fasting β cell function index and insulin sensitivity index between two groups（P＆gt;0.05）.Conclusions Abnormal maternal glucose metabolism in pregnancy has no effect on early pancreatic islet function in premature infant,however,proinsulin secretion has been affected.