目的 研究小于胎龄儿(small for gestaional age, SGA)生后至学龄前期生长方式与胰岛素抵抗的关系。方法 采用前瞻性研究方法, 分析68名SGA与42名适于胎龄儿(appropriate for gestaional age, AGA)生后3 d和4周岁时空腹血糖、胰岛素及稳态模型评估(HOMA-IR、HOMA-β)值, 以及SGA不同生长方式与上述指标的关系。结果 SGA生后3 d和4周岁时空腹胰岛素及HOMA-IR值均显著高于AGA(P<0.05);SGA中无体重追赶生长儿胰岛素及HOMA-IR值均显著高于有体重追赶生长儿(P<0.01);但HOMA-β值在各组中差异无统计学意义(P>0.05)。结论 SGA在生后至学龄前期出现胰岛素抵抗;且无体重追赶生长儿胰岛素抵抗水平更高;但胰岛β细胞分泌功能无明显改变。

Objective To explore the relationship between growth pattern from birth to preschool age and insulin resistance. Methods Fasting glucose, insulin, HOMA-IR and HOMA-β value in 68 small for gestaional age(SGA) infants and 42 appropriate for gestaional age(AGA) infants at age 3-day and 4-year were studied by a prospective study, and the relations with growth pattern were analyzed in 68 SGA infants. Results SGA infants had significantly higher fasting insulin concentration and HOMA-IR value than AGA infants at age 3-day and 4-year (P<0.05).No catch-up growth of weight in SGA infants had significantly higher fasting insulin concentration and HOMA-IR value than catch-up growth of weight in SGA infants(P<0.01).There was no significant difference in HOMA-β value among each groups (P>0.05). Conclusions SGA infants display insulin resistance from birth to preschool age.No catch-up growth of weight in SGA infants have higher insulin resistance.The function of β-cell of pancreatic islands has no remarkable change.