Document Detail

Intrauterine growth restriction and postnatal steroid treatment effects on insulin sensitivity in preterm neonates.
MedLine Citation:
PMID:  12378184     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To study whether intrauterine growth restriction (IUGR) is associated with decreased sensitivity to the main fetal growth factor, insulin, and the effect of glucocorticoid therapy on insulin sensitivity in preterm infants. STUDY DESIGN: Newborn infants with a birth weight (BW) of< 1500 g were classified as appropriate for gestational age ([AGA], BW within +/- 1 SD, n = 10), or small for gestational age ([SGA], BW <-2 SD, n = 13); 5 AGA infants and 8 SGA infants received systemic steroids. An abbreviated modified minimal model test was performed, consisting of sequential blood samples for glucose and insulin assays, and intravenous infusions of 0.3 g/kg glucose and 0.02 U/kg regular human insulin. The insulin sensitivity index (S(I)) was calculated using a computer program. RESULTS: The basal insulin/glucose ratio (I/G) and S(I) did not differ between the AGA and SGA groups. Steroids did not influence the I/G nor the S(I) of AGA infants (10.2 +/- 6.7 vs 8.2 +/- 2.3), but decreased the S(I) in the SGA group (12.2 +/- 5.1 vs 5.3 +/- 2.7, P <.05). CONCLUSIONS: Insulin sensitivity of neonates can be measured by the modified minimal model. IUGR is not associated with impaired fetal glucose tolerance. Early neonatal steroid treatment decreases insulin sensitivity in SGA infants, which may contribute to their risk of having hyperglycemia.
Jaana A Leipälä; Kari O Raivio; Annikki Sarnesto; Antonios Panteleon; Vineta Fellman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  141     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-14     Completed Date:  2002-11-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  472-6     Citation Subset:  AIM; IM    
Hospital for Children and Adolescents, University of Helsinki, Finland.
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MeSH Terms
Blood Glucose / drug effects,  metabolism
Fetal Growth Retardation / blood,  drug therapy*
Infant Welfare
Infant, Newborn
Infant, Premature / blood,  growth & development*
Infant, Small for Gestational Age / blood,  growth & development*
Insulin / blood
Postnatal Care*
Sensitivity and Specificity
Steroids / therapeutic use*
Treatment Outcome
Reg. No./Substance:
0/Blood Glucose; 0/Steroids; 11061-68-0/Insulin
Comment In:
J Pediatr. 2002 Oct;141(4):459-62   [PMID:  12378178 ]

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