低出生体质量儿血浆ghrelin与胰岛素敏感性关系探讨

The Relationship between Ghrelin and Insulin Sensitivity in Low Birth Weight Infants

目的:探讨ghrelin对低出生体质量儿宫内胰岛素敏感性改变的影响,以及胰岛素抵抗对日后发生相关疾病发病机制的影响。方法:收集我院及中心妇产科医院出生的新生儿43例,分低出生体质量组(LBW组)22例和正常出生体质量组(NBW组)21例,监测生后血糖、出生体质量、身长、头围及胸围。酶联免疫法分别测定脐血ghrelin及胰岛素水平,计算胰岛素敏感指数(ISI)及稳态模型胰岛素抵抗指数(HOMA-IR)。结果:2组血糖差异无统计学意义(P>0.05),LBW组胰岛素及胰岛素抵抗指数低于NBW组(P<0.05),ghrelin及胰岛素敏感指数高于NBW组(均P<0.05)。LBW组ghrelin水平与胰岛素及胰岛素抵抗指数呈负相关(均P<0.01),与胰岛素敏感指数呈正相关(P<0.05),而与血糖无明显相关性(P>0.05);NBW组ghrelin水平与胰岛素呈负相关(P<0.05),与胰岛素敏感指数、胰岛素抵抗指数及血糖无明显相关性(均P>0.05)。结论:Ghrelin是低出生体质量儿为适应宫内环境而进行的内分泌调整过程中的重要因素,参与了胰岛素敏感性改变和胰岛素抵抗的发展进程。

Objective： To evaluate the relationship of ghrelin and insulin sensitivity in low birth weight infants, and the development of perinatal insulin resistance/ metabolic syndrome thereof. Methods： According to the weight of birth, 43 neonates were divided into two groups, low birth weight group（LBW, n = 22） and normal birth weight group（NBW, n = 21）. The weight, height, head circumference, chest circumference, the weight of placenta, glucose, ghrelin and insulin were measured. The insulin sensitive index （ISI） and insulin resistance index were calculated. Results： There was no significant difference in the blood glucose between two groups （P 0.05）. The insulin and insulin resistance index were lower, and the ghrelin level and ISI were higher in LBW group compared with those of NBW group （P 0.05）. The level of umbilical cord ghrelin was negatively correlated with insulin and insulin resistance index （P 0.01）, was positively correlated with ISI in LBW group, and no correlation with glucose （P 0.05）. The level of umbilical cord ghrelin was negatively correlated with insulin （P 0.05）, and was no correlation with ISI, insulin resistance index and glucose in NBW group （P 0.05）. Conclusion： Ghrelin may participate in the process of insulin resistance in the low birth weight infants, which probably prevents insulin sensitivity, or delays the development of insulin resistance.