目的:探讨极低出生体重(VLBW)婴儿入院期间的葡萄糖相关激素分布,并评估新生儿高血糖与胰岛素抵抗之间的关系。
方法:一项前瞻性观察性研究-极低出生体重儿,葡萄糖和荷尔蒙随时间的分布研究。
方法:瑞典县医院的三级新生儿重症监护病房和四个新生儿病房。
方法:2016-2019年出生<1500g(VLBW)的48名婴儿。
方法:葡萄糖相关激素和蛋白质的血浆浓度(C肽,胰岛素,ghrelin,胰高血糖素样肽1(GLP-1),胰高血糖素,瘦素,抵抗素和胰岛素原),胰岛素:C肽和胰岛素原:胰岛素比率,恒定性模型评估2(HOMA2)和定量胰岛素敏感性检查(QUICKI)指数,在生命日(DOL)7和月经后36周时测量。
结果:胎龄较低与血糖升高显著相关,C-肽,胰岛素,胰岛素原,瘦素,ghrelin,抵抗素和GLP-1浓度,HOMA2指数增加,QUICKI指数和胰岛素原:胰岛素比降低。高血糖婴儿的血糖明显升高,C-肽,胰岛素,瘦素和胰岛素原浓度,和较低的QUICKI指数,比血糖正常的婴儿。更高的葡萄糖和胰岛素原浓度以及胰岛素:C肽比,DOL7的较低QUICKI指数与入院期间高血糖持续时间延长显著相关。
结论:VLBW婴儿似乎具有与胰岛素抵抗一致的激素谱。较低的胎龄和高血糖与较高浓度的胰岛素抵抗标志物有关。
To explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period.
A prospective observational
study-the Very Low Birth Weight Infants, Glucose and Hormonal Profiles over Time
study.
A tertiary neonatal intensive care unit and four neonatal units in county hospitals in Sweden.
48 infants born <1500 g (VLBW) during 2016-2019.
Plasma concentrations of glucose-related hormones and proteins (C-peptide, insulin, ghrelin, glucagon-like peptide 1 (GLP-1), glucagon, leptin, resistin and proinsulin), insulin:C-peptide and proinsulin:insulin ratios, Homoeostatic Model Assessment 2 (HOMA2) and Quantitative Insulin Sensitivity Check (QUICKI) indices, measured on day of life (DOL) 7 and at postmenstrual age 36 weeks.
Lower gestational age was significantly associated with higher glucose, C-peptide, insulin, proinsulin, leptin, ghrelin, resistin and GLP-1 concentrations, increased HOMA2 index, and decreased QUICKI index and proinsulin:insulin ratio. Hyperglycaemic infants had significantly higher glucose, C-peptide, insulin, leptin and proinsulin concentrations, and lower QUICKI index, than normoglycaemic infants. Higher glucose and proinsulin concentrations and insulin:C-peptide ratio, and lower QUICKI index on DOL 7 were significantly associated with longer duration of hyperglycaemia during the admission period.
VLBW infants seem to have a hormone profile consistent with insulin resistance. Lower gestational age and hyperglycaemia are associated with higher concentrations of insulin resistance markers.