新生儿脐血瘦素、甘油三酯及胆固醇变化的研究

A study of changes of leptin,cholesterol and triglyceride in cord blood of newborns

目的观察新生儿脐血中的瘦素(leptin)、胆固醇(CHO)及甘油三酯(TG)水平,分析这些指标变化与胎儿生长的关系,探讨早期评估IUGR的方法。方法103例新生儿脐血标本分为三组:(1)小于胎龄儿组(SGA):30例;(2)适于胎龄儿(AGA)组:41例;(3)大于胎龄儿(LGA)组:32例。采用高敏酶免疫分析法测定新生儿脐血中瘦素水平,全自动生化分析仪测定TG、CHO水平。结果(1)脐血瘦素水平AGA、SGA、LGA三组差异有统计学意义(F=17.75,P<0.01);SGA组(0.7147±0.5761)ng/ml显著低于AGA组(2.710±0.4329)ng/ml(P<0.01),而AGA组低干LGA组(5.687±0.3916)ng/ml(P<0.05)。脐血瘦素水平随胎龄及出生体重增加而增加(r分别= 0.332和0.654,P均<0.01)。(2)脐血TG水平AGA、SGA、LGA三组差异有统计学意义(F=8.85,P<0.05);SGA组(0.7141±0.1576)mmol/l显著高于AGA组(0.5027±0.1330)mmol/l(P<0.01)及LGA组(0.4907±0.1397)mmol/L(P<0.01),而AGA组与LGA组之间差异无统计学意义(P>0.05)。TG与出生体重呈负相关(r=- 0.320,P=0.050),与胎龄无相关性(r=0.129,P>0.05)。(3)脐血CHO水平AGA、SGA、LGA三组分别为(1.685±0.1121)mmol/L,(1.947±0.2079)mmol/L和(1.661±0.142)mmol,差别无统计学意义(F=1.28,P>0.05)。脐血CHO水平与出生体重及胎龄无相关性(r分别=0.208和0.133,P均>0.05)。(4)脐血瘦素与TG呈负相关关系(r=0.280,P<0.05),与CHO无相关性(r=-0.117,P>0.05)。结论结果提示IUGR新生儿血脂代谢异常;脐血瘦素水平降低可作为判断胎儿生长发育迟缓的一项客观实用的指标。

Objective： To investigate the serum leptin, cholesterol（CHO） and triglyceride（TG） in cord blood of newborns, analyze the relationships among their levels and prenatal growth, and explore a method to evaluate prenatal growth early. Methods ： The samples of cord blood were collected from the departments of Obstetrics of Taian City Central Hospital. The cases were divided into the three groups ： （ 1 ） small for gestational age （SGA） or intrauterine growth retardation （IUGR） group （ n = 30） ; （2） appropriate gestational age （ AGA ） group （ n = 41 ） ; （ 3 ） large for gestational age （ LGA ） group （n = 32）. The serum leptin level was measured by enzyme amplified sensitivity immunoassay （EASIA） ;the serum CHO and TG level by auto-biochemistry analysis machine. Results： （ 1 ） The concentrations of leptin among three groups were significantly different （ F = 17.75, P 〈 0.01 ）. SGA group （ 0.7147 ± 0. 5761 ） ng/ml was lower than AGA group （ 2.710 ± 0.4329 ） ng/ml （ P 〈 0.01 ） , and AGA group was lower than LGA group （ 5. 687 ± 0.3916 ） ng/ml （ P 〈 0.05 ）. Leptin level increased with gestational age anti birth weight （r = 0. 332, P 〈 0.01;r=0. 645, P 〈 0.01, respectively）. （2） The concentrations of TG among three groups were significantly different（ F = 8.85 ,P 〈 0.01 ）. SGA group （0. 7141±0. 1576） mmol/l was higher than AGA group （0. 5027 ± 0.1330）mmol/l（ P 〈 0.01 ）and LGA group（0. 4907 ± 0. 1397 ）mmol/l, but the difference between AGA group and LGA group had not statistical significance （ P 〉 0.05 ）. TG level reduced with birth weight （ r = -0. 320, P = 0.05 ） and had no correlation with gestational age（ r = 0. 129,P 〉 0.05 ）. （ 3 ） The concentrations of CHO were not different among three groups （ F = 1.28, P 〉 0.05 ）. The level of CHO had no correlation with birth weight and gestational age （ r = 0. 208 ,P 〉 0.05 ;r =0. 133 ,P 〉0.05 ,respectively）. （4） The level of leptin was correlated to the level of TG（ r = - 0.280, P 〈 0.05 ） but not to CHO （ r = - 0. 1 17,P 〉 0.05 ）. Conclusion ： The results indicate that the fat metabolism of newborns with IUGR is abnormal and the concentrations of leptin can be an objective and practical index for the evaluation of prenatal growth.