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　　一項研究表明，早產出生的成年人在中年時出現胰島素抵抗，但這種現象與其子女的胰島素抵抗不相關。為了評價早產出生的成年人及其子女的胰島素敏感性和分泌功能。新西蘭奧克蘭大學霍夫曼教授選取早產和足月產的成年人，以及他們足月產的子女（5-10歲）作為試驗對象進行了一項研究。評價胰島素敏感性和分泌功能，在成年組中采用高血糖鉗夾試驗，在兒童組中采用最小量的伯格曼靜脈葡萄糖耐量試驗。該研究結果發表在《糖尿病》（Diabetes）雜志2012年10月份第61卷。

　　在該試驗中，成年組共入選52位（34-48歲），其中31位為早產兒出生，其平均孕期為33.3周；兒童共入選61位，平均年齡為7.9 ± 0.3歲，其中37位為早產出生成年人的子女。

　　研究發現，早產出生的成年人胰島素敏感性稍低于足月產成年人（19.0 ± 2.5 vs. 36.3 ± 5.2 mg kg 1 min 1mU L；P< 0.05），第一時相胰島素代償性分泌增加（56.1 ± 8.5 vs. 25.3 ± 3.7 mU/L；P< 0.001），二者相似的胰島素分布曲線表明與機體相適應的胰島素分泌。這些區別在不同性別之間無差異，排除孕期小于32周的試驗對象后這些區別仍然存在。早產與足月產出生的成年人的子女胰島素分泌功能相似，父母與子女胰島素敏感性的顯著性相關性表現在足月產出生的父母與其子女之間。

　　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.