Original ArticlesIntrauterine growth restriction and postnatal steroid treatment effects on insulin sensitivity in preterm neonates☆,☆☆
Section snippets
Subjects
The study was performed in the Neonatal Intensive Care Unit of the Hospital for Children and Adolescents, University of Helsinki, between April 1998 and December 2000. Infants with a BW <1500 g and an indwelling arterial line were eligible if the BW was <–2 SD (small for gestational age [SGA]) or within ± 1 SD range (appropriate for gestational age [AGA]) (Table I).Gestational ages were determined by fetal ultrasonography. Mothers of all AGA and SGA infants received antenatal steroid (in one
Results
There were no significant differences in sex and gestational age between the 2 study groups (Table I), nor between the AGA and SGA infants not receiving postnatal steroid. The lowest and highest blood glucose concentrations during the MMM did not differ between the groups (Table II).Empty Cell Before insulin administration After insulin administration Empty Cell AGA SGA AGA SGA Lowest blood glucose 6.3 ± 2.1 (3.7-9.6) 7.4 ± 3.3 (3.7-14.4)
Discussion
Reduced glucose tolerance has been observed in 2 rat models of IUGR, after maternal semistarvation15, 16 and placental insufficiency caused by uterine artery ligation (the offspring studied at 3-4 months of age).17 In humans, clinically significant IUGR often results in an extremely preterm birth, but no data have been reported on the insulin sensitivity of newborn SGA infants. The glucose clamp technique has been applied to measure insulin sensitivity in AGA preterm infants.18, 19 The clamp
Acknowledgements
We thank Dr Richard N. Bergman for fruitful discussions.
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Supported by the Finnish Pediatric Research Foundation and the Medical Society of Finland (Finska Läkarsällskapet).
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Reprint requests: Jaana A. Leipälä, 4th Floor, Ruskin Wing, King's College Hospital, London SE5 9RS, United Kingdom.