A Study On The Association Between Fetal Growth Retardation And The Change Of Insulin Sensitivity In The Neonates

Objectives To explore the relationship of fetal growth retardation (FGR) and the change of neonatal insulin sensitivity by studying on the consequences of glucose and plasma lipid metabolism in early postnatal life (48—72 hr after delivery), moreover, it will provide the theoretical basis for further exploring onset and development of metabolic syndrome (MS) and fetal growth retardation. Methods 72 neonates with small for gestational age (SGA) (as case) and 48 neonates with appropriate for gestational age (AGA) (as control) were studied by using radioimmuoassay (RIA) and other methods. Fasting plasma glucose (FPG) Fasting insulin (FINS) leptin (LEP) High density lipoprotein-cholesterol (HDL-C) Low density lipoprotein-cholesterol (LDL-CX Triglyceride (TG) Non esterified fatty acids (NEFA) were performed, glucose/insulin ratio (G/I) insulin sensitivity index (ISI) insulin resistance index (HOMA-IR), the function of β -cell of pancreatic islands (HCBI), etc. were calculated, and the association of the change of neonatal insulin sensitivity with FGR was analysed. Results The level of physical development with SGA neonates were lower than that of AGA neonates, there was no significant difference in gestational age between two groups (33.9+2.8 vs 34.5 + 2.1 week, P> 0.05) .(1)The results of FPG FINS C-peptide, LEP The level of FPG of SGA neonates was lower than that of AGA neonates (3. 72 + 0.68mmol/L vs4.28±0. 93mmol/L P<0,01) but the level of FINS. C-peptide was higher ( 2. 30±0.45ulu/ml vs 1. 77±0.49ulu/ml, P< 0.01; 0. 27±0.05ug/ml vs -0. 21 ±0.06ug/ml, P<0.01); the level of LEP of SGA neonates was lower than that of AGA neonates (0. 31±0.03ug/ml vs 0. 79+0. 34ug/ml, P<0.0l) .(2) The results of plasma lipid metabolism The level of HDL-C of SGA neonates was lower than that of AGA neonates (-1.24±0.17mmol/L vs 0.14±0.02mmol/L, P<0.01), but the level of LDL-C, TG. NEFA of SGA neonates was higher (0.72±0.02mmol/L vs 0.46±0.03amol/L, P<0.01; 0.07±0.04mmol/L vs -0. 58±0. 05mmol/L, P<0. 01; 0. 46+0.14mmol/L vs 0. 32±0.12mmol/L, P<0.01). (3)The results of the change of insulin sensitivity G/I ratio. ISI of SGA neonates was lower than that of AGA neonates (1.89±0.45mg/dl/ulu/ml vs 2.55±0.53mg/dl/uIu/ml, p<0.01; -3.61+0.55 vs-3.21+0.54, p<0.01), HOMA-IR of SGA neonates was higher (0.51±0.06 vs -0.01±0.07, P< 0.01) .However, there was no significant difference in HBCI between two groups (178. 3±96.5 vs 127.1+45.9, P>0.05) . Conclusions FGR neonates displayed an remarkable hyperinsulinemia, which indicates hyperinsulinemia is one of the most striking characteristics of the change of insulin sensitivity in early posLnatal life. In addition, FGR neonates had already significantly had dyslipidaemia decreased insulin sensitivity and to some extent had developed IR.However, in early postnatal life HBCI of FGR neonates was normal, which indicates in early postnatal life the change of the function of cell of pancreatic islands of FGR neonates is chronologically and gradually developed course and is affected by environmental factors.