早产儿胰岛素抵抗的影响因素分析OA
Analysis of influencing factors of insulin resistance in premature infants
目的 分析胎龄<32周的早产儿胰岛素抵抗(IR)的影响因素.方法 选取2022年3月至2024年6月该院收住的111例早产儿为研究对象,根据出生后第14天是否发生IR分为IR组(n=53)和非IR组(n=58).收集母亲、早产儿一般资料及临床相关数据,并检测代谢和氧化应激指标,采用逐步logistic回归分析早产儿IR发生的影响因素.结果 与非IR组比较,IR组新生儿高血糖发生率更高(18.9%vs.3.5%),经鼻无创通气时间更长[144.0(48.0,216.0)h vs.89.5(0,156.5)h],早产儿胰岛素(14.44 mU/L vs.11.67 mU/L)、脂联素[1 860.20(1 315.82,2 091.36)pg/mL vs.1 540.61(1 320.48,1 803.21)pg/mL]、瘦素[3.06(2.68,3.80)μg/mL vs.2.68(2.38,3.15)μg/mL]、血糖[5.00(4.38,5.61)mmol/L vs.3.71(3.40,4.24)mmol/L]、超氧化物歧化酶[SOD,26.75(12.90,45.71)U/mL vs.17.51(9.20,36.73)U/mL]、丙二醛(MDA,0.96 nmol/mL vs.0.60 nmol/mL)、晚期氧化蛋白产物[AOPP,39.84(35.76,49.80)μmol/L vs.36.85(31.02,41.74)μmol/L]水平更高,差异有统计学意义(P<0.05).多因素logistic回归分析结果显示,新生儿高血糖(OR=8.04,95%CI:1.51～42.05)、MDA(OR=4.07,95%CI:1.19～16.04)、AOPP(OR=1.09,95%CI:1.03～1.16)是IR发生的影响因素(P<0.05).结论 氧化应激可能参与了早产儿IR的发生.
Objective To analyze the influencing factors of insulin resistance(IR)in premature infants with gestational age less than 32 weeks.Methods A total of 111 premature infants admitted to the hospital from March 2022 to June 2024 were selected as the research subjects and divided into the IR group(n=53)and the non-IR group(n=58)based on whether IR occurred 14 days after birth.Baseline characteristics and clinical data of the mothers and premature infants were collected,and metabolic and oxidative stress indicators were measured.Stepwise logistic regression analysis was used to explore the influencing factors of IR occur-rence in premature infants.Results Compared with the non-IR group,the incidence of neonatal hyperglycemia in the IR group was higher(18.9%vs.3.5%),and the duration of non-invasive nasal ventilation was longer[144.0(48.0,216.0)h vs.89.5(0,156.5)h].The levels of insulin[14.44(12.92,16.77)mU/L vs.11.67(10.59,12.89)mU/L],adiponectin[1 860.20(1 315.82,2 091.36)pg/mL vs.1 540.61(1 320.48,1 803.21)pg/mL],leptin[3.06(2.68,3.80)μg/mL vs.2.68(2.38,3.15)μg/mL],blood glucose[5.00(4.38,5.61)mmol/L vs.3.71(3.40,4.24)mmol/L],superoxide dismutase[SOD,26.75(12.90,45.71)U/mL vs.17.51(9.20,36.73)U/mL],malondialdehyde[MDA,0.96(0.66,1.11)nmol/mL vs.0.60(0.46,0.83)nmol/mL],and advanced oxidation protein products[AOPP,39.84(35.76,49.80)μmol/L vs.36.85(31.02,41.74)μmol/L]were higher,and the differences were statistically significant(P<0.05).The results of multivariate logis-tic regression analysis showed that neonatal hyperglycemia(OR=8.04,95%CI:1.51-42.05),MDA(OR=4.07,95%CI:1.19-16.04),and AOPP(OR=1.09,95%CI:1.03-1.16)were the influencing factors for IR(P<0.05).Conclusion Oxidative stress may be involved in the occurrence of IR in premature infants.
何建平;王永明;汪珍;丁丽;刘芙君;马剑
宁夏医科大学附属银川市妇幼保健院:新生儿科,银川 750001宁夏医科大学附属银川市妇幼保健院:新生儿科,银川 750001宁夏医科大学附属银川市妇幼保健院:新生儿科,银川 750001宁夏医科大学附属银川市妇幼保健院:儿科规培基地,银川 750001宁夏医科大学附属银川市妇幼保健院:儿科规培基地,银川 750001宁夏医科大学附属银川市妇幼保健院:儿科规培基地,银川 750001
医药卫生
早产儿胰岛素抵抗影响因素代谢氧化应激
premature infantsinsulin resistanceinfluencing factorsmetabolismoxidative stress
《重庆医学》 2026 (6)
1201-1207,7
宁夏自然科学基金项目(2025AAC031041)宁夏医科大学校级基金项目(XM2023215).
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