早产儿瘦素、胰岛素水平及其与生长发育的关系

Levels of Serum Leptin and Insulin and Their Relationships with Growth and Development in Preterm Infants

目的探讨早产儿血清瘦素、胰岛素水平及其与生长发育的关系。方法采用放射免疫法检测37例早产儿出生24h内和第10天静脉血瘦素、胰岛素水平;并对其出生时生长发育指标进行测量和血糖、血脂检查。同时检测20例足月儿出生24h内瘦素、胰岛素水平。采用SPSS10.0软件进行统计学分析。结果早产儿瘦素、胰岛素水平明显低于足月儿[(6.45±2.24)μg/Lvs(8.56±1.33)μg/L,(5.84±1.07)IU/Lvs(10.85±5.24)IU/LPa<0.05]。早产儿出生第10天血清瘦素明显下降[(6.45±2.24)μg/Lvs(3.64±1.10)μg/LP<0.05];胰岛素水平显著增加[(5.84±1.07)IU/Lvs(8.44±3.54)IU/LP<0.05]。早产儿出生24h内瘦素、胰岛素水平与其胎龄、头围、身长、出生体质量、体质量指数均呈正相关(Pa<0.05),与血糖、血脂、恢复至出生体质量的天数均无明显相关性(Pa>0.05);胎龄<34周和≥34周早产儿瘦素水平与胰岛素水平均呈正相关(Pa<0.01),瘦素与胰岛素/血糖无相关性(P>0.05)。结论瘦素、胰岛素水平可作为反映胎儿发育和营养状况的指标;早产儿体内可能存在脂胰轴,并在胎龄34周前即发挥作用,但功能尚不成熟;瘦素、胰岛素的早期变化对调节早产儿代谢和促进生长发育具有重要意义。

Objective To explore the levels of serum leptin and insulin and their relationships with growth and development in premature Methods The serum leptin and insulin conceotrations of 37 premature infants were examined by the radioimmunoassay （day 1 and day 10 ,respectively）, and antbropometric measurements were performed at birth. The blood sugar and triglyeride ,cholesterol were tested at the same time. Twenty full - term newborn without severe diseases were contled in 24 h after delivery and the level of leptin and insulin of them were detected, too. The results were analysed by SPSS 10.0 software. Results The leptin and insulin levels in preterm infants were significantly lower than those in full - term infants[ （6.45 ±2.24） μg/L t= （8.56 ± 1.33 ） μg/L, （5.84 ± 1.07 ） IU/L vs （ 10.85 ± 5. 24 ） IU/L P 〈 0.05 ]. Ten days later, the leptin level of preterm infants decreased significantly [ （6.45 ± 2.24 ） μg/L vs （ 3.64 ± 1.10） μg/L P 〈 0.05 ], while the insulin level significantly increased[ （5.84 ± 1.07 ） IU/L vs （ 8.44± 3.54） IU/L P 〈 0.05 ]. Both serum leptin and insulin were correlated with gestation age, head circurnference,body length, birth weight, body mass index （P, 〈 0.05 ） , but there were no correlation with serum glucose, cholesterol, triglyeride and the days the days return to birth weight （Pa 〉 0.05 ）. Serum leptin was positive correlation with serum insulin （P 〈 0.01 ） both before and after 34 gestation age, but there was no correlation between leptin and insulin/glucose （ P 〉 0.05 ）. Conclusions Serum leptin and insulin can be the markers that reflect intrauterine nutrition status of preterm infants and the growth and development of fetus. A dipoinsular axis may be functional before 34 weeks gestation without maturity. The changes of leptin and insulin concentrations are useful for metabolism and growth in preterm infants.