Diabetes：早产出生的成年人更容易出现胰岛素抵抗

　　一项研究表明，早产出生的成年人在中年时出现胰岛素抵抗，但这种现象与其子女的胰岛素抵抗不相关。为了评价早产出生的成年人及其子女的胰岛素敏感性和分泌功能。新西兰奥克兰大学霍夫曼教授选取早产和足月产的成年人，以及他们足月产的子女（5-10岁）作为试验对象进行了一项研究。评价胰岛素敏感性和分泌功能，在成年组中采用高血糖钳夹试验，在儿童组中采用最小量的伯格曼静脉葡萄糖耐量试验。该研究结果发表在《糖尿病》（Diabetes）杂志2012年10月份第61卷。

　　在该试验中，成年组共入选52位（34-48岁），其中31位为早产儿出生，其平均孕期为33.3周；儿童共入选61位，平均年龄为7.9 ± 0.3岁，其中37位为早产出生成年人的子女。

　　研究发现，早产出生的成年人胰岛素敏感性稍低于足月产成年人（19.0 ± 2.5 vs. 36.3 ± 5.2 mg kg 1 min 1mU L；P< 0.05），第一时相胰岛素代偿性分泌增加（56.1 ± 8.5 vs. 25.3 ± 3.7 mU/L；P< 0.001），二者相似的胰岛素分布曲线表明与机体相适应的胰岛素分泌。这些区别在不同性别之间无差异，排除孕期小于32周的试验对象后这些区别仍然存在。早产与足月产出生的成年人的子女胰岛素分泌功能相似，父母与子女胰岛素敏感性的显著性相关性表现在足月产出生的父母与其子女之间。

　　Insulin sensitivity and β-cell function in adults born preterm and their children

　　Abstract

　　We aimed to evaluate insulin secretion and insulin sensitivity in adults born preterm and their children. Subjects were adults born both preterm and at term, with their children aged 5-10 years born at term. Insulin sensitivity and secretion were assessed using hyperglycemic clamps in adults and frequently sampled intravenous glucose tolerance tests using Bergman minimal model in children. In total, 52 adults aged 34-38 years participated (31 born preterm, mean gestational age 33.3 weeks). Adults born preterm were less insulin sensitive than those born at term (19.0 ± 2.5 vs. 36.3 ± 5.2 mg · kg(-1) · min(-1)mU · L; P < 0.05) with compensatory increased first-phase insulin secretion (56.1 ± 8.5 vs. 25.3 ± 3.7 mU/L; P < 0.001) but similar disposition index indicating appropriate insulin secretion. These differences were independent of sex and remained when subjects born <32 weeks' gestation were excluded from analyses. In total, 61 children were studied (37 of preterm parents, mean age 7.9 ± 0.3 years). Children of parents born preterm had similar insulin sensitivity to children of parents born at term, but a correlation between parental and offspring insulin sensitivity was noted only among children of parents born preterm. In conclusion, adults born preterm have insulin resistance in midadulthood, but this was not associated with insulin resistance in their children.