Factors associated with neonatal hyperinsulinemic hypoglycemia, a case-control study
Issued Date
2024-01-01
Resource Type
ISSN
0334018X
eISSN
21910251
Scopus ID
2-s2.0-85182879141
Pubmed ID
38235510
Journal Title
Journal of Pediatric Endocrinology and Metabolism
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SCOPUS
Bibliographic Citation
Journal of Pediatric Endocrinology and Metabolism (2024)
Suggested Citation
Rattanasakol T., Kitsommart R. Factors associated with neonatal hyperinsulinemic hypoglycemia, a case-control study. Journal of Pediatric Endocrinology and Metabolism (2024). doi:10.1515/jpem-2023-0526 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95994
Title
Factors associated with neonatal hyperinsulinemic hypoglycemia, a case-control study
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Abstract
We aimed to identify perinatal risk factors associated with hyperinsulinemic hypoglycemia in neonates. Secondary objectives included an examination of clinical and biochemical characteristics at the time of diagnosis and an exploration of the duration of diazoxide therapy. A case-control study was conducted, involving individual chart reviews of inborn infants diagnosed with hyperinsulinemic hypoglycemia (the HH group) between 2014 and 2021. These cases were paired with controls (the non-HH group) belonging to the same gestational age (GA) strata who did not exhibit HH or only had transient postnatal hypoglycemia. A total of 52 infants with HH were matched with corresponding controls. The mean GA in the HH group was 34.4 ± 3.1 weeks. Notably, the HH group exhibited lower mean minimum plasma glucose (PG) levels and required higher glucose infusion rates in comparison to the non-HH group (26.5 ± 15.6 vs. 49.1 ± 37.7 mg/dL and 12.9 ± 3.8 vs. 5.7 ± 2.1 mg/kg/min, respectively; p<0.001 for both). After adjusting for potential confounding factors, only two variables, fetal growth restriction (FGR) and neonatal sepsis, demonstrated significant associations with HH (adjusted odds ratio [95 % confidence interval]: 8.1 [2.1-31.0], p=0.002 and 6.3 [1.9-21.4], p=0.003, respectively). The median duration of diazoxide therapy for the HH group was 4 months. FGR and neonatal sepsis emerged as notable risk factors for HH. These infants exhibited lower PG levels and necessitated higher glucose infusion rates compared to their non-HH counterparts. Importantly, a substantial proportion of the HH group received diazoxide therapy, with a median treatment duration of 4 months.