胎儿生长迟缓与新生儿胰岛素敏感性变化的相关性

目的探讨胎儿生长迟缓(FGR)与新生儿胰岛素敏感性变化的关系。 方法昆明医学院第一附属医院于2004年4~12月，对72例小于胎龄儿(SGA)和48例适于胎龄儿(AGA)空腹血糖(FPG)、空腹胰岛素(FINS)、C 肽、HDL C、LDL C、TG、非酯化脂肪酸(NEFA)等指标，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)等，探讨FGR与新生儿胰岛素敏感性变化的关系。 结果(1)SGA组FPG、HDL C低于AGA组，而FINS、LDL C、TG、NEFA高于AGA组(P<001)；(2)SGA组G/I比值、ISI低于AGA组，HOMA IR高于AGA组(P<001)，而HBCI两组相比差异无显著性(P>005)。 结论FGR儿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。

A study on the association between fetal growth retardation and the change of insulin sensitivity in the neonates.

AbstractObjectiveTo explore the relationship between fetal growth retardation(FGR)and the change of insulin sensitivity in neonates. MethodsFrom April 2004 to December 2004,72 small for gestational age infants(SGA)and 48 appropriate for gestational age infants(AGA)were selected in the present study in the First Affiliated Hospital of Kunming Medical College.Fasting plasma glucose(FPG),fasting insulin(FINS),high density lipoprotein cholesterol(HDL C),low density lipoprotein cholesterol(LDL C),triglyceride(TG) and non esterified fatty acids(NEFA) were assayed;glucose/insulin ratio (G/I)、insulin sensitivity index(ISI)、insulin resistance index(HOMA IR)，the function of β cell of pancreatic islands(HCBI)，etc.were calculated.Explore the relationship between FGR and the change of insulin sensitivity in neonates. ResultsThe level of FPG and HDL C in SGA group was lower than that in AGA group，but the level of FINS、LDL C、TG and NEFA was higher(P<001).G/I ratio、ISI in SGA group were lower than that in AGA group.HOMA IR was higher(P<001).However，there was no significant difference in HBCI between two groups. ConclusionIn early postnatal life FGR neonates display decreased insulin sensitivity and insulin resistance (IR)to some extent.However，the function of β cell of pancreatic islands has no remarkabe change.