脂联素、瘦素及胰岛素样生长因子-Ⅰ在胎儿生长发育中的作用

Roles of Adiponectin,Leptin and Insulin Like Growth Factor-Ⅰin Fetus Growth and Development

目的探讨脂联素、瘦素及胰岛素样生长因子-Ⅰ（IGF—Ⅰ）在胎儿生长发育中的作用。方法选择2006年10月-2007年10月在本院产科出生的新生儿86例。胎龄31—42周；男57例，女29例。根据不同出生体质量分为小于胎龄儿（SGA）组（16例），适于胎龄儿（AGA）组（41例）及大于胎龄儿（LGA）组（29例）。胎儿娩出后立即断脐留脐血20mL，采用放射免疫分析法测定血清脂联素、瘦素及IGF—Ⅰ水平，同时检测其血脂水平，测量新生儿生长参数，计算体质量指数（BMI）。结果1．新生儿脐血瘦素、脂联素及IGF—Ⅰ水平无显著性别差异。2．脐血瘦素水平在SGA、AGA、LGA3组间有显著差异（P〈0．001），LGA组显著高于AGA及SAG组（P〈10．01，0．001）；脐血瘦素水平与体质量、胎龄、头围、身长、足长及胎盘质量均呈显著正相关（Pa〈0．01）。3．脐血脂联素水平与出生体质量、头围、足长、BMI水平均呈显著正相关（Pa〈0．05）。脐血脂联素水平在SGA、AGA、LGA3组间有显著差异（P〈0．001），LGA组高于AGA及SAG组（Pa〈0．01）。4．LGA组脐血IGF—Ⅰ水平显著高于AGA及SAG组，3组间有明显差异（P〈0．001）；脐血IGF—Ⅰ水平与体质量、头围、身长、足长及胎盘质量均呈显著正相关（Pa〈0．01）。5．脐血瘦素与脂联素、IGF—Ⅰ水平呈显著正相关（Pa〈0．01），脐血脂联素与IGF—Ⅰ水平无明显相关关系（P〉0．05）。6．SGA、AGA、LGA3组血脂水平比较无显著差异（Pa〉0．05）。脐血IGF—Ⅰ水平与三酰甘油水平呈明显负相关（P〈0．05），脐血脂联素、瘦素水平与血脂各指标间均无明显相关性（Pa〉0．05）。结论瘦素与脂联素、IGF-Ⅰ在胎儿宫内生长和发育过程中起重要的调节作用，可作为评价胎儿生长发育及营养状态的临床指标之一。

Objective To explore the roles of adiponectin,leptin and insulin like growth factor- Ⅰ （IGF- Ⅰ ） in fetus growth and development. Methods Eighty - six newborn infants between Aug. 2006 and Aug. 2007 in our hospital obstetrics, whose fetal age between 31 to 42 weeks,including male 57 example, female 29 exam.pie were selected. According to gestation age and birth weight percentile relation, they were divided into the small for gestational age （ SGA ） group （ n = 16 ） , the appropriate for gestational age （AGA） group （ n = 41 ）, and the large for gestational age （LGA） group （n = 29 ）, After fetus expulsion, bellybutton were immediately cut off to keep cord blood 20 mL, and levels of cord blood adiponectin, leptin and IGF - Ⅰ were examined by radio immunoassay （RIA）. The level of blood fat was detected, and neonatal growth parameter, compute body mass index（BMI） were measured. Results 1. The levels of cord blood adiponectin, leptin and IGF - Ⅰ had no significantly different with neonatal sexuality. 2. The levels of cord blood leptin had significantly different between SGA, AGA and LGA groups（ P 〈 0. 001 ）, that of LGA group was significantly higher than that of AGA group and SGA group （P 〈 0.01,0. 001 ） ;The level of cord blood leptin were positively correlated with their birth weight, gestational age, head circumference, body length, foot length and placental weight （ Pa 〈 0.01 ）. 3. The level of cord blood adiponectin were positively correlated with their birth weight, head circumference, foot length and BMI （ Pa 〈 0.05 ）. The levels of cord blood adiponectin had significantly different between SGA, AGA and LGA groups （ P 〈 0. 001 ）, that of LGA group was higher than that of AGA group and SGA group（Pa 〈0. 01 ）. 4. The levels of cord blood IGF - Ⅰ in LGA group was significantly higher than AGA group and SGA group,and had significantly different between SGA, AGA and LGA groups （P 〈 0. 001 ） , the levels of cord blood IGF- Ⅰ were positively correlated with their birth weight, head circumference, body length, foot length and placental weight （Pa 〈 0. 01 ）. 5. The levels of cord blood leptin were positively correlated with adiponectin and IGF - Ⅰ （ P 〈 0. 01 ） , the levels of cord blood adiponectin and IGF - Ⅰ had no positively correlated（ P 〉 0.05 ）. 6. The levels of cord blood blood fat in between SGA, AGA and LGA groups had no significantly different （Pa 〉 0.05 ）, the levels of cord blood adiponectin, leptin with blood fat indexes had no positively correlated （P 〉 0.05 ）. Conclusions Cord blood adiponectin, leptin and IGF - Ⅰ play an important roles in adjust fetus growth and development, they can be regarded as one of the clinical indexes to evaluate fetus growth and development or nutrient.