Abstract：
OBJECTIVE: To describe glucose homeostasis disturbances (dysglycaemia) in very low-birthweight infants (<1500 g) during the admission period and explore associated risk factors.
METHODS: The LIGHT (very low-birthweight infants - glucose and hormonal profile over time) study was a prospective observational cohort study that included 49 very low-birthweight infants admitted to the tertiary neonatal intensive care unit in Umeå, Sweden, during 2016-2019. All glucose concentrations (n = 3515) sampled during the admission period were registered.
RESULTS: Hyperglycaemia >10 mmol/L and hypoglycaemia <2.6 mmol/L were registered in 63% and 55% of the infants, respectively. Onset of dysglycaemia occurred almost exclusively in the first postnatal week. Hyperglycaemia followed 15% of corticosteroid doses given; all were preceded by pre-existing hyperglycaemia. Pre-existing hyperglycaemia was found in 66.7% of hyperglycaemic infants who received inotrope treatment. Upon commencement, 72.5% of antimicrobial treatments given were neither preceded nor followed by hyperglycaemia.
CONCLUSIONS: Dysglycaemia was common in very low-birthweight infants. Daily means of glucose concentrations seemed to follow a postmenstrual age-dependent pattern, decreasing towards term age suggesting a postmenstrual age-dependent developmental mechanism. The primary mechanism causing hyperglycaemia was independent of sepsis, and corticosteroid and inotrope treatments. No hypoglycaemia was registered during ongoing insulin treatment.
METHODS: The LIGHT (very low-birthweight infants - glucose and hormonal profile over time) study was a prospective observational cohort study that included 49 very low-birthweight infants admitted to the tertiary neonatal intensive care unit in Umeå, Sweden, during 2016-2019. All glucose concentrations (n = 3515) sampled during the admission period were registered.
RESULTS: Hyperglycaemia >10 mmol/L and hypoglycaemia <2.6 mmol/L were registered in 63% and 55% of the infants, respectively. Onset of dysglycaemia occurred almost exclusively in the first postnatal week. Hyperglycaemia followed 15% of corticosteroid doses given; all were preceded by pre-existing hyperglycaemia. Pre-existing hyperglycaemia was found in 66.7% of hyperglycaemic infants who received inotrope treatment. Upon commencement, 72.5% of antimicrobial treatments given were neither preceded nor followed by hyperglycaemia.
CONCLUSIONS: Dysglycaemia was common in very low-birthweight infants. Daily means of glucose concentrations seemed to follow a postmenstrual age-dependent pattern, decreasing towards term age suggesting a postmenstrual age-dependent developmental mechanism. The primary mechanism causing hyperglycaemia was independent of sepsis, and corticosteroid and inotrope treatments. No hypoglycaemia was registered during ongoing insulin treatment.
摘要：
目的：描述极低出生体重婴儿（<1500g）入院期间的血糖稳态紊乱（血糖异常），并探讨相关的危险因素。
方法：LIGHT（极低出生体重婴儿-葡萄糖和荷尔蒙随时间的变化）研究是一项前瞻性观察性队列研究，其中包括49名极低出生体重婴儿入住于默奥三级新生儿重症监护病房，瑞典,2016-2019年。登记在入院期间采样的所有葡萄糖浓度(n=3515)。
结果：高血糖>10mmol/L和低血糖<2.6mmol/L的婴儿分别占63％和55％，分别。血糖异常的发作几乎仅发生在产后第一周。高血糖症遵循给予的皮质类固醇剂量的15％；所有这些都是先前存在的高血糖症。在接受inotrope治疗的高血糖婴儿中，有66.7％发现了先前存在的高血糖。一开始,给予的72.5％的抗菌治疗既没有在高血糖之前也没有在高血糖之后。
结论：血糖异常在极低出生体重婴儿中很常见。每日葡萄糖浓度的平均值似乎遵循月经后年龄依赖性模式，随着足月年龄的下降，这表明了月经后年龄依赖性的发育机制。引起高血糖的主要机制独立于脓毒症，以及皮质类固醇和肌力疗法。在正在进行的胰岛素治疗期间没有记录到低血糖。
方法：LIGHT（极低出生体重婴儿-葡萄糖和荷尔蒙随时间的变化）研究是一项前瞻性观察性队列研究，其中包括49名极低出生体重婴儿入住于默奥三级新生儿重症监护病房，瑞典,2016-2019年。登记在入院期间采样的所有葡萄糖浓度(n=3515)。
结果：高血糖>10mmol/L和低血糖<2.6mmol/L的婴儿分别占63％和55％，分别。血糖异常的发作几乎仅发生在产后第一周。高血糖症遵循给予的皮质类固醇剂量的15％；所有这些都是先前存在的高血糖症。在接受inotrope治疗的高血糖婴儿中，有66.7％发现了先前存在的高血糖。一开始,给予的72.5％的抗菌治疗既没有在高血糖之前也没有在高血糖之后。
结论：血糖异常在极低出生体重婴儿中很常见。每日葡萄糖浓度的平均值似乎遵循月经后年龄依赖性模式，随着足月年龄的下降，这表明了月经后年龄依赖性的发育机制。引起高血糖的主要机制独立于脓毒症，以及皮质类固醇和肌力疗法。在正在进行的胰岛素治疗期间没有记录到低血糖。
