Glucose regulation in young adults with very low birth weight
Glucose regulation in young adults with very low birth weight
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DOI：
10.1056/nejmoa067187
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发表时间：
2007-05-17
影响因子：
158.5
通讯作者：
Kajantie, Eero
中科院分区：
文献类型：
--
作者：
Hovi, Petteri;Andersson, Sture;Kajantie, Eero
背景：在足月出生的人中，出生时身材矮小与以后生活中血糖调节受损之间的关系已经得到了很好的证实。极低出生体重（< 1500 g）的早产也与儿童期胰岛素抵抗有关。如果胰岛素抵抗持续到成年期，极低出生体重的早产也可能与成年期疾病风险增加有关。我们评估了极低出生体重的年轻成人的葡萄糖耐量和胰岛素敏感性，并测量了血脂水平和血压。研究方法：我们进行了一项标准的75克口服葡萄糖耐量试验，测量了163名极低出生体重的年轻人（年龄范围，18至27岁）和169名足月出生且胎龄不小的受试者的基线和120分钟时的胰岛素和葡萄糖浓度。两组在年龄、性别和出生医院方面相似。我们测量了血压和血脂水平，并在150极低出生体重的受试者和136例足月出生的受试者中，我们还通过双能X线吸收法测量了身体成分。结果如下：与足月出生的受试者相比，极低出生体重受试者的2小时血糖浓度增加6.7（95%置信区间[CI]，0.8 - 12.9），空腹胰岛素浓度增加16.7%（95% CI，4.6 - 30.2），2小时胰岛素浓度增加40.0%（95%CI，17.5 - 66.8），通过稳态模型评估确定的胰岛素抵抗指数增加18.9%（95% CI，5.7至33.7），收缩压升高4.8 mm Hg（95% CI，2.1至7.4）。在极低出生体重的受试者中调整较低的瘦体重并没有减弱这些关系。结论：出生体重极低的年轻人比足月出生的人有更高的胰岛素抵抗指数和葡萄糖耐受不良指数以及更高的血压。
Background: The association between small size at birth and impaired glucose regulation later in life is well established in persons born at term. Preterm birth with very low birth weight (< 1500 g) is also associated with insulin resistance in childhood. If insulin resistance persists into adulthood, preterm birth with very low birth weight also may be associated with an increased risk of disease in adulthood. We assessed glucose tolerance and insulin sensitivity and measured serum lipid levels and blood pressure in young adults with very low birth weight. Methods: We performed a standard 75-g oral glucose-tolerance test, measuring insulin and glucose concentrations at baseline and at 120 minutes in 163 young adults (age range, 18 to 27 years) with very low birth weight and in 169 subjects who had been born at term and were not small for gestational age. The two groups were similar with regard to age, sex, and birth hospital. We measured blood pressure and serum lipid levels, and in 150 very-low-birth-weight subjects and 136 subjects born at term, we also measured body composition by means of dual-energy x-ray absorptiometry. Results: As compared with the subjects born at term, the very-low-birth-weight subjects had a 6.7% increase in the 2-hour glucose concentration (95% confidence interval [CI], 0.8 to 12.9), a 16.7% increase in the fasting insulin concentration (95% CI, 4.6 to 30.2), a 40.0% increase in the 2-hour insulin concentration (95% CI, 17.5 to 66.8), an 18.9% increase in the insulin-resistance index determined by homeostatic model assessment (95% CI, 5.7 to 33.7), and an increase of 4.8 mm Hg in systolic blood pressure (95% CI, 2.1 to 7.4). Adjustment for the lower lean body mass in the very-low-birth-weight subjects did not attenuate these relationships. Conclusions: Young adults with a very low birth weight have higher indexes of insulin resistance and glucose intolerance and higher blood pressure than those born at term.