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目的旨在探讨2~4岁足月小于胎龄儿出生后早期生长追赶与胰岛素抵抗的关系。方法采用1∶1配对的研究方法,分析44对足月小于胎龄(small for gestational age,SGA)儿和足月适于胎龄(appropriate for gestational age,AGA)儿的生长发育情况及稳态模型的胰岛素抵抗指数、胰岛素敏感性指数、胰岛β细胞功能指数,及生长追赶与以上指标的关系。结果 SGA儿出生时生长发育指标、0~6月龄期生长追赶指标与AGA儿差异均有统计学意义(P<0.05)。2~3岁组、3~4岁组SGA儿胰岛素抵抗指标低于AGA儿,胰岛素敏感指标高于AGA儿,差异均有统计学意义(P<0.05)。小于4岁组0~6月龄期身长Z积分增值与Homa-IAI呈正相关;大于4岁组7~12月龄期体重Z积分增值与Homa-IR呈正相关。结论 SGA儿早期存在明显的生长追赶现象,尚未出现胰岛素抵抗,胰岛素敏感、胰岛素抵抗的改变都是随着时间的推移而出现逐渐变化的过程。
The purpose of this study was to investigate the relationship between early childhood growth catch-up and insulin resistance after birth in 2 ~ 4 years old infants of less than gestational age. Methods A 1:1 paired study was conducted to analyze the growth and metastasis of 44 children with term for gestational age (SGA) and term suitable for gestational age (AGA) The insulin resistance index, insulin sensitivity index, pancreatic β-cell function index, and the relationship between growth catch-up and the above indexes were analyzed. Results The indexes of growth and development at birth of SGA children were statistically significant (P <0.05). The level of insulin resistance in SGA children aged 2-3 years and 3-4 years old was lower than that in AGA children, and the insulin sensitivity index was higher than that in AGA children (P <0.05). There was a positive correlation between the increase of Z-score and Homa-IAI in 0 ~ 6-month-old children younger than 4 years old. The positive value of Z-score of body weight in 7-to 12-month-old children older than 4 years old was positively correlated with Homa-IR. Conclusions There is a clear phenomenon of catch-up in early stage of SGA. Insulin resistance, insulin sensitivity and changes of insulin resistance have not yet appeared in the process of gradual change with time.