宫内生长迟缓儿脐血内脂素水平与胰岛素、生长激素水平的关系

Relationship between Cord Blood Visfatin and Insulin,Growth Hormone in Newborn Infants with Intrauterine Growth Retardation

目的探讨内脂素调节胎儿生长发育的可能作用机制。方法选择足月出生的宫内生长迟缓(IUGR)儿、巨大儿及健康足月儿各30例,采用ELISA法测定其脐血内脂素水平,采用放射免疫法测定其胰岛素、生长激素(GH)水平,分析脐血内脂素、胰岛素、GH水平与出生体质量的关系,及脐血内脂素水平与胰岛素、GH水平间的关系。结果 IUGR组、巨大儿组和健康对照组新生儿脐血内脂素水平分别为(0.758±0.522)μg.L-1、(0.359±0.150)μg.L-1、(0.431±0.343)μg.L-1,三者比较差异有统计学意义(P=0.003);胰岛素水平分别为(9.76±1.86)mIU.L-1、(13.99±2.96)mIU.L-1、(16.92±5.12)mIU.L-1,三者比较差异有统计学意义(P=0.000);GH分别为(8.48±2.86)μg.L-1、(10.23±2.25)μg.L-1、(10.48±2.35)μg.L-1,三者比较差异有统计学意义(P=0.029)。相关性分析显示,脐血内脂素水平与出生体质量呈负相关(r=-0.416,P=0.001),脐血胰岛素水平与出生体质量呈正相关(r=0.318,P=0.013),脐血内脂素水平与胰岛素无相关(P>0.05)。脐血GH水平与出生体质量、脐血内脂素水平均无相关性(Pa>0.05)。结论 IUGR与内脂素、胰岛素等内分泌激素有关,可通过调节代谢而影响胎儿宫内的生长发育。

Objective To investigate the possible mechanisms of visfatin in regulating fetal growth.Methods Ninety term neonates were divided into intrauterine growth retardation（IUGR） group,fetal macrosomia group and healthy term infants group,and each group included 30 cases.Cord blood plasma concentration of visfatin was measured by enzyme-linked immunosorbent assay,while concentrations of insulin and growth hormone（GH） were measured by radioimmunoassay（RIA）.Results Concentrations of visfatin,insulin and GH were significant differents in 3 groups[visfatin：（0.758±0.522） μg·L-1 vs（0.359±0.150）μg·L-1 vs（0.431±0.343） μg·L-1,P=0.003;insulin：（9.76±1.86） mIU·L-1 vs（13.99±2.96） mIU·L-1 vs（16.92±5.12） mIU·L-1,P=0.000;GH：（8.48±2.86） μg·L-1 vs（10.23±2.25） μg·L-1 vs（10.48±2.35） μg·L-1,P=0.029].Insulin level was positively（r=0.318,P=0.013）,while visfatin level was inversely（r=-0.416,P=0.001） correlated with birth weight.There was no significant correlation between cord blood visfatin and insulin（P0.05）.The concentration of GH was neither significantly correlated with birth weight nor visfatin（Pa0.05）.Conclusion The cord blood levels of visfatin and insulin may play an important role in the pathophysiological changes in IUGR.