Insulin resistance in short children with intrauterine growth retardation
Insulin resistance in short children with intrauterine growth retardation
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DOI：
10.1210/jc.82.2.402
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发表时间：
1997-02-01
影响因子：
5.8
通讯作者：
Gluckman, PD
中科院分区：
文献类型：
--
作者：
Hofman, PL;Cutfield, WS;Gluckman, PD
流行病学研究表明，胎儿宫内发育迟缓与成人疾病风险增加之间存在关联，这些疾病包括高血压、非胰岛素依赖型糖尿病和缺血性心脏病。这些疾病的一个共同特征是胰岛素抵抗。为了研究胰岛素敏感性异常是否是宫内生长迟缓(IUGR)患者的特征，我们比较了两组矮小的青春期前儿童：IUGR组(出生体重小于10%；n=15)和正常出生体重组(n=12)。受试者接受了改良的频繁取样静脉葡萄糖耐量试验，以计算急性胰岛素反应、胰岛素敏感指数和葡萄糖有效性。两组之间的胰岛素敏感指数有显著差异，宫内发育迟缓组的胰岛素敏感性较低[6.9vs.16.9×10(-4)min(-1)](单位单位/毫升)；P=0.0048。两组间的急性胰岛素反应也有显著差异，宫内发育迟缓组的胰岛素水平较高(445mU/m l比174mU/m L；P=0.005)。两组间的血糖有效性没有差异。与正常出生体重的同龄人相比，青春期前IUGR儿童的胰岛素敏感性有特殊的损害。在短小的IUGR儿童中，胰岛素敏感性受损是早期识别和干预晚期成人起病的非胰岛素依赖型糖尿病的潜在标记物。
Epidemiological studies have demonstrated an association between intrauterine growth retardation and an increased risk of adult diseases that include essential hypertension, noninsulin-dependent diabetes mellitus, and ischemic heart disease. A common feature of these diseases is insulin resistance.To investigate whether abnormal insulin sensitivity was a characteristic of subjects with intrauterine growth retardation (IUGR), we compared two groups of short prepubertal children: a group with IUGR (birth weight less than the tenth percentile; n = 15) and a normal birth weight group (n = 12). Subjects underwent a modified frequently sampled iv glucose tolerance test that permitted calculation of the acute insulin response, insulin sensitivity index, and glucose effectiveness.A marked difference in the insulin sensitivity index was noted between groups, with the IUGR group being less insulin sensitive [6.9 vs. 16.9 10(-4) min(-1).(mu U/mL); P = 0.0048]. The acute insulin response was also significantly different between groups, with IUGR subjects having higher insulin levels (445 vs. 174 mu U/mL; P = 0.005). There was no difference in glucose effectiveness between groups.Short prepubertal IUGR children have a specific impairment in insulin sensitivity compared to their normal birth weight peers. In short IUGR children, impaired insulin sensitivity is a potential marker for the early identification and intervention in the development of late adult-onset noninsulin-dependent diabetes mellitus.