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目的:研究大于胎龄(LGA)儿是否存在胰岛素敏感性异常。方法:选取2011年5月~2012年1月在大连市妇幼保健院娩出的84例足月新生儿分为3组,母亲妊娠期糖尿病(GDM)LGA儿(LGA-GDM)32例,母亲非GDM LGA儿(LGA-non-GDM)27例,适于胎龄(AGA)儿25例。生后1 h内测量体重、身长,计算体重指数(BMI)。生后24~48 h空腹状态下采集股静脉血,电化学发光法测定胰岛素水平(FINS),全自动生化分析仪测定甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)以及葡萄糖(FPG)。稳态模型评估(HOMA)胰岛素敏感性和胰岛分泌功能(HBCI)。结果:3组FPG、TG、TC、HDL-C和LDL-C水平差异无统计学意义(P>0.05)。LGA-GDM组和LGA-non-GDM组的FINS水平差异无统计学意义(P>0.05),均高于AGA组(P<0.05)。LGA-GDM组和LGA-nonGDM组的胰岛素抵抗指数(IRI)和胰岛素敏感指数(ISI)差异均无统计学意义(P>0.05),IRI均>AGA组(P<0.01),ISI均0.05)。结论:LGA儿胰岛素敏感性降低。
PURPOSE: To investigate the presence of insulin sensitivity abnormalities in children older than gestational age (LGA). Methods: A total of 84 full-term newborns delivered from May 2011 to January 2012 in Dalian MCH were divided into 3 groups: 32 pregnant women with gestational diabetes mellitus (LGA-GDM), 32 mothers GDM LGA children (LGA-non-GDM) in 27 cases, suitable for gestational age (AGA) in children 25 cases. Body weight, body length and body mass index (BMI) were measured within 1 h after birth. Blood samples were collected from 24 to 48 hours after birth, the levels of insulin were measured by electrochemiluminescence assay (FINS), triglyceride (TG), total cholesterol (TC) and high density lipoprotein cholesterol HDL-C), low-density lipoprotein cholesterol (LDL-C), and glucose (FPG). Steady state model assessment (HOMA) insulin sensitivity and islet secretion (HBCI). Results: The levels of FPG, TG, TC, HDL-C and LDL-C in the three groups had no significant difference (P> 0.05). There was no significant difference in FINS levels between LGA-GDM group and LGA-non-GDM group (P> 0.05), all of which were higher than that of AGA group (P <0.05). There was no significant difference in insulin resistance index (IRI) and insulin sensitivity index (ISI) between LGA-GDM group and LGA-nonGDM group (P> 0.05), IRI> AGA group (P <0.01) Group (P <0.05). There was no significant difference in HBCI between the three groups (P> 0.05). Conclusion: LGA insulin sensitivity decreased.