母血脐血胰岛素、糖脂水平测定及其意义

Insulin, glucose and lipid levels in maternal and cord blood

【目的】 测定小于胎龄儿 (SGA)、适于胎龄儿 (AGA)、大于胎龄儿 (LGA)母血脐血胰岛素 (INS)、糖脂水平并分析其相关因素 ,探讨不同宫内环境下胎儿INS、糖脂水平变化及意义。 【方法】 均选取无明显产科并发症的剖宫产母亲及其新生儿 ,其中SGA 2 0例 ,AGA 2 7例 ,LGA 2 1例。采用ELISA法测定INS ,葡萄糖氧化酶法测定血糖 (Glu) ,大型生化仪测定甘油三脂 (TG)和胆固醇 (CHOL)。 【结果】 ①LGA组母血脐血INS水平明显高于SGA组和AGA组 (P <0 .0 5 ) ,SGA组与AGA组母血脐血之间INS水平差异无统计学意义 (P >0 .0 5 ) ;LGA组母血TG水平明显高于SGA、AGA组 (P <0 .0 5 )。SGA组脐血TG水平明显高于AGA和LGA(P <0 .0 5 ) ,三组母血脐血血糖、CHOL差别无统计学意义 (P >0 .0 5 )。②母血与脐血INS、TG、CHOL、血糖水平之间无相关性 ;母血INS水平与胎儿的体格发育指标无相关性。③SGA组母亲孕前体块指数 (BMI)明显低于AGA组及LGA组 (P <0 .0 5 ) ,后两者之间差别无统计学意义。LGA组母亲孕期体重增加明显高于SGA组及AGA组 (P <0 .0 5 )。母亲孕前BMI、孕期体重增加、身高与胎儿出生体重呈正相关。。 【结论】 不同的宫内环境引起胎儿内分泌及代谢的改变 ,SGA儿的TG水平明显升高及LGA儿的高胰岛素血症可能?

To investigate the differences of the levels in insulin (INS), glucose (Glu) and lipid and the meaning of their changes in the different intrauterine environments. According to the birth weight and gestational age, there were 3 classes of paired mothers and neonates by cesarean section to be studied, 20 cases of the total with small for gestational age (SGA), 27 cases with appropriate for gestational age (AGA) and 21 cases with large for gestational age (LGA). The birth weight, birth length and head circumference were recorded for each neonate. The maternal heights, weight before pregnancy and weight before cesarean section were also recorded. The levels of INS in 3 groups were measured by ELISA and the concentrations of Glu in 3 groups were measured by the glucose oxidase peroxidase method. An automatic biochemical apparatus was used to measure the levels of triglycerides (TG) and cholesterol (CHOL). ① The levels of insulin in both mother and neonate in group LGA were significantly higher than that in group AGA and SGA ( P <0.05), but there were no significantly difference between SGA and AGA. The maternal blood TG levels in LGA were significantly higher than that in group SGA and AGA. The cord blood TG levels in group SGA were significantly higher than that in group AGA ( P =0.026) and LGA ( P =0.003). There were no significant differences of the levels of Glu and CHOL among the three groups neither in maternal or in cord blood. ② The INS, TG, Glu and CHOL levels in cord blood were not correlated with their maternal blood. There was no relationship between the INS levels in the cord blood and the birth weight. ③ The maternal body mass index before pregnancy in SGA group was significantly lower than that in AGA and LGA group ( P <0.05). And the maternal weight gain during the pregnancy in LGA group was much higher than the other two groups ( P <0.05). The maternal height, body mass index before pregnancy and weight gain during pregnancy were correlated positively with the birth weight of the newborns. [Conclusions] The fetal endocrine and metabolism might be changed by abnormal intrauterine environments. This may be long effects in the postnatal life; The level of INS in the cord blood could not be used to predict the neonatal birth weight; The nutrition status before and during pregnancy in gravida is still one of the important factors for the fetal growth.