出生巨大儿和儿童期体质指数对胰岛素抵抗和C肽的影响

目的探讨出生巨大儿和儿童期体质指数(BMI)对胰岛素抵抗和C肽的影响。方法对无锡市1993-1995年建立的巨大儿队列于2005-2007年进行随访,每个对象按"出生日期±2个月"、"性别"匹配一个正常体重儿。在两组各抽取150名对象进行问卷调查和空腹血糖、胰岛素和C肽的检测,并测量身高、体重。结果巨大儿组的胰岛素抵抗(HOMA-IR)指数和空腹C肽(pmol/ml)分别为(2.55±1.45)、(0.39±0.23);略高于正常体重儿组,但其差异无统计学意义(P=0.10、0.07)。BMI与IR和C肽呈正相关。肥胖组的IR指数为(3.96±2.22),高于超重组(2.60±0.92)和正常组(2.36±1.33);C肽为肥胖组(0.75±0.43)超重组(0.50±0.25)正常组(0.35±0.20)。多因素分析发现随着BMI的增加,IR指数、空腹C肽含量均显著增加。结论儿童BMI升高是胰岛素抵抗和C肽升高的危险因素,应合理控制儿童的体质指数,防治肥胖发生。

Study on the Effects of Macrosomia and BMI on Insulin Resistance and C-peptide in Childhood

Objective To explore the effects of macrosomia and body mass index （BMI） on insulin resistance and C- pep- tide（CP） in children. Methods A cohort of macrosomia and normal birth weight neonates matched by birth - date and gen- der, born in 1993 to 1995 in Wuxi, were followed up in 2005 - 2007. 150 objects were sampled from each group. A question- naire survey was conducted, and the height, weight, blood glucose, insulin and C - peptide were measuredl Results The means of insulin resistance （HOMA- IR） index and fasting CP level （pmol/ml） of the macrosomia group were （2.55 ± 1.45） and （0.39 ±0.23）, respectively, which were a little bit higher than those of the normal birth weight group, but not significantly different （P = 0.10 and P = 0.07）. The BMI had positive correlations with IR and CP. In the obesity group, the IR index was 3.96± 2.22, whieh was significantly higher than that in the overweight group （2.60± 0.92） and BMI normal group （2.36± 1.33）. Moreover, the CP in the obesity group （0.75±0.43） was higher than that in the overweight group （0.50 ± 0.25） and that in the BMI normal group （0.35± 0.20）. Multivariate analysis indicated that the IR index and fasting CP level increased with the increase of BMI. Conclusions High BMI is the risk factor of insulin resistance and C- peptide increase in child- hood. The BMI of the children should be reasonably controlled to prevent overweight and obesity.