脐血瘦素与妊娠糖尿病新生儿体质指标的关系

Analysis of Relationship of Leptin and Neonatal Body Index in Mothers with Gestational Diabetes Mellitus

【目的】探讨在血糖控制良好的妊娠糖尿病(GDM)孕妇中,脐血瘦素与新生儿体质指标的关系。【方法】收集2006年11月至2007年2月于我科住院分娩的孕妇150例,其中糖代谢异常,包括GDM和妊娠期糖耐量异常(GIGT),而且血糖控制良好的孕妇73例,糖耐量正常的孕妇77例,其新生儿分为大于胎龄儿(LGA)25例和适于胎龄儿(AGA)125例两组。比较分析了两组新生儿的体质指标、脐血瘦素等指标。【结果】LGA与AGA相比,脐血的瘦素水平LGA组的更高(16.17±12.53vs10.84±8.41μg/L,P<0.05)。在糖代谢异常孕妇的新生儿中,LGA新生儿的出生体质量与脐血的瘦素水平正相关(r=0.974,P<0.05);在糖耐量正常孕妇的新生儿中,LGA新生儿的体质指标与脐血瘦素不相关。【结论】脐血瘦素与新生儿体质量密切相关;脐血瘦素可能参与了糖代谢异常孕妇分娩LGA的发病机制。

[Objectives] To analyze the relationship between cord blood leptin and neonatal body index in the mothers with gestational diabetes mellitus （GDM） and to explore how leptin plays a role in fetal growth. [ Methods ] This study recruited 150 GDM mothers and their babies admitted in our hospital from November 2006 to February 2007. There were 73 cases of abnormal glucose metabolism with good control of blood glucose and 77 cases of normal glucose tolerance. Their babies were divided into 25 cases of large for gestational age （LGA） and 125 cases of appropriate for gestational age （AGA）. To analyze their clinical datas such as neonatal body index and to detect serum leptin in cord blood by radioimmunity. [Resuhs]LGA＇s cord blood Leptin level was higher than that in AGA group （16.17 ± 12.53 vs 10.84 ± 8.41 μg/L, P 〈 0.05）. In newborns of abnormal glucose metabolism mothers, LGA＇s birth body weight was positively correlated with cord blood Leptin（r=0.974,P 〈 0.05）. In newborns of NGT mothers, LGA＇s body index was not correlated with cord blood leptin. [Conclusions ] LGA compared with normal glucose tolerance, cord blood leptin is higher. It is indicated that cord blood leptin may play a role in the mechanism of fetal overgrowth in abnormal glucose metabolism mothers.