早产和足月新生儿血清瘦素与出生体重及胰岛素关系分析

Relation of serum leptin to birth weight and insulin in preterm and term neonates

目的研究早产和足月新生儿血清瘦素与出生体重及胰岛素关系,探讨在早产和足月新生儿中是否存在脂肪-胰岛素内分泌轴。方法共收集264例早产和足月新生儿,按胎龄进行分组,并进行出生测量,于生后第3天采血做餐前血糖、胰岛素及瘦素检查。结果足月儿血清瘦素浓度显著高于早产儿,瘦素浓度与胎龄的关系按非线性模式增加,胎龄34周以后,瘦素浓度增加明显加快。在>32周的新生儿中,血清瘦素浓度与出生体重及胰岛素呈正相关关系(r=0.240,0.227,P<0.05),在胎龄≥37周的新生儿中,瘦素不仅与出生体重及胰岛素呈正相关(r=0.198,0.253,P<0.05),还与胰岛素/血糖呈正相关(r=0.206,P<0.05),在<32周的新生儿中,未发现上述关系。结论胎龄>32周的新生儿体内可能已开始存在脂肪-胰岛素内分泌轴。

Objective To investigation the relation of leptin to birth weight and insulin in preterm and term neonates and to explore whether a functional “adipoinsular axis” might exist in preterm and term neonates. Methods A total of 264 preterm and term newborns were recruited and categorised according to gestation length. Anthropometric measurements were performed at birth. Leptin, fasting glucose and insulin were measured at 3 days of life. Results Serum leptin was significantly higher in term than in preterm. The relation between serum leptin and gestation followed a non-linear pattern; The slope of the curve began to increase after 34 weeks gestation. Serum leptin was associated with birth weight and insulin in newborn more than 32 weeks gestation（r=0. 240, 0. 227, P〈 0. 05, respectively）. Serum leptin in newborn 37 or more weeks gestation was associated with not only birth weight and insulin （r = 0. 198, 0. 253, P〈 0.05, respectively） but also insulin： glucose （r = 0. 206, P〈0.05）. However, those associations were not observed in newborn less than 32 weeks gestation. Conclusions Adipoinsular axis might exist in newborn more than 32 weeks gestation.