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Z Geburtshilfe Neonatol 2021; 225(02): 146-154
DOI: 10.1055/a-1338-0461
Originalarbeit

Der Insulin-Unterschied von Jungen und Mädchen bei Geburt

Insulin Difference of Boys and Girls at Birth
Hans Gottfried Simon
1   Gynäkologie und Geburtshilfe, Walburga Krankenhaus, Meschede, Deutschland
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Zusammenfassung

Einleitung Ob Mädchen bei Geburt höhere Insulinspiegel haben als Jungen ist umstritten. Klärung sollen die Insulinwerte von 863 in Folge geborenen Kindern bringen, deren Mütter kein Screening auf Gestationsdiabetes hatten.

Methodik Nabelschnurserum, mit einem handelsüblichen Insulintest bestimmt, wird retrospektiv auf geschlechtsabhängige Insulinunterschiede untersucht.

Ergebnisse Mädchen zeigen höhere Medianwerte als Jungen (♀6,0/♂5,2 µU/ml). Die Insulin-Geschlechts-Differenz beträgt 0,8 µU/ml [95% KI 0,3 bis 1,3], p -Wert 0,003. Sie wird ebenfalls bei AGA-Kindern, bei Neugeborenen von Mehrgebärenden, nach primärer Sectio caesarea und spontaner vaginaler Geburt gefunden (0,8/1,2/1,7/0,9 µU/ml; p-Werte 0,003/0,001/0,025/0,006). Makrosome (LGA/≥4000 g) Mädchen von Mehrgebärenden weisen die höchsten Insulinwerte (13,8/13,8 µU/ml) und die höchste Insulin-Geschlechts-Differenz auf (5,5/5,6 µU/ml, p-Werte 0,001/0,001). Erstgeborene, die weniger als 3640 g wiegen, zeigen diese Insulindifferenz, aber ≥ 4060 g existiert eine inverse Insulin-Geschlechts-Differenz (-5,4 µU/ml; p-Wert 0,023) mit höheren Insulinwerten von Jungen (11,3 µU/ml). Kinder mit Hyperinsulinämie (≥ 20 µU/ml) (17♀/11♂) zeigen keine Insulin-Geschlechts-Differenz, Mädchen wiegen mehr als Jungen (154 g, p-Wert 0,463), Geschwisterkinder 695 g mehr (p-Wert 0,0001) als Erstgeborene.

Schlussfolgerung Höhere Insulinwerte der Mädchen bei Geburt werden bestätigt. Eine bislang nicht bekannte inverse Insulindifferenz mit höheren Insulinwerten makrosomer erstgeborener Jungen wird nachgewiesen.

Abstract

Background Different opinions exist whether girls show higher insulin levels than boys at birth. Insulin values of 863 consecutively born babies whose mothers had no screening for gestational diabetes may provide clarification.

Method Cord serum, measured with a commercially available insulin assay, is therefore retrospectively analyzed for insulin differences in boys and girls.

Results Girls show higher insulin values than boys (♀6.0/♂5.2 µU/ml). Insulin-sex-difference amounts to 0.8 µU/ml [95% CI 0.3 to 1.3]; p-value 0.003. It is also found in AGA babies, in children of multiparous women, after elective caesarean section and spontaneous vaginal delivery (0.8/1.2/1.7/0.9 µU/ml; p-values 0.003/0.001/0.025/0.006). Girls of multiparous women with macrosomia (LGA/≥ 4000 g) show the highest values of insulin (13.8/13.8 µU/ml) and of insulin-sex-difference (5.5/5.6 µU/ml, p-value 0.001/0.001). This insulin difference can be seen in firstborn babies weighing less than 3640 g, but ≥ 4060 g an inverse insulin sex difference (-5.4 µU/ml; p-value 0.023) with higher insulin values in boys exists (11.3 µU/ml). Children with hyperinsulinaemia (≥20 µU/ml) (17♀, 11♂) show no insulin difference, girls weigh more than boys (154 g, p-value 0.463) and later born babies more (695 g, p-value 0.0001) than firstborns.

Conclusion Higher insulin values of girls have been confirmed. An as yet unknown inverse insulin difference with higher insulin values of firstborn boys with macrosomia has been proved.

Schlüsselwörter

Insulin (Nabelschnurserum) - Gestationsdiabetes - fetale Gewichtsschätzung - Nabelschnurblut

Key words

cord insulin - gestational diabetes - foetal weight estimation - umbilical cord blood


Publication History

Received: 30 June 2020

Accepted after revision: 07 December 2020

Article published online:
18 January 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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