Risk Factors for Insulin Resistance in Preterm Infants: A Case- Control Study

Background Preterm infants are at higher risk for metabolic dysregulation, including insulin resistance (IR), which may contribute to adverse outcomes. This study aimed to identify predictors of IR in preterm infants and to explore their metabolic and oxidative stress profiles. Methods A case-control study was conducted involving 111 preterm infants (gestational age < 34 weeks) at Yinchuan Women and Children Healthcare Hospital from March 2022 to June 2023. Infants were stratified into insulin-resistant (IR, n = 53) and non-insulin-resistant (Non-IR, n = 58) groups. Data on maternal and neonatal characteristics were collected alongside laboratory investigations of metabolic markers and oxidative stress indicators. The SPSS 25.0 was used for statistical analysis. IR risk factors in preterm infants were identified through conditional logistic regression analysis. P value < 0.05 was considered statistically significant. Results Significant differences were observed between groups; the IR group exhibited elevated fasting insulin (14.44 vs. 11.67 mU/L, P  < 0.001), fasting blood glucose (5.00 vs. 3.71mmol/L, P  < 0.001), Adiponectin(1860.20vs.1540.61pg/mL, P  = 0.025), Leptin(10.71 vs.9.38 µg/mL, P  = 0.001), malondialdehyde (MDA; 0.96 vs. 0.60 nmol/mL, P  < 0.001), and advanced oxidation protein products (AOPP: 39.84 vs. 36.85µmol/L, P  = 0.002). Logistic regression identified MDA ( aOR  = 4.00, P  = 0.032) and AOPP ( aOR  = 1.09, P  = 0.002) as independent predictors of IR. Hyperglycemia was more prevalent in the IR group during the early postnatal phase ( aOR  = 8.04, P  = 0.015). Conclusion This study underscores the metabolic and oxidative stress dysregulation associated with IR in preterm infants, suggesting that elevated MDA and AOPP levels may be critical risk factors.