摘要
目的:探讨Ghrelin与新生儿胰岛素-胰岛素样生长因子轴的关系,进一步揭示其对新生儿生长发育及能量代谢的影响。方法:选择62例新生儿,按胎龄、体重分为足月儿、早产儿、适于胎龄儿(appropriate for gestational age,AGA)和小于胎龄儿(small for gestational age,SGA)。其中胎龄30~34周14例,34+1~37周14例,37+1~41周34例。足月SGA13例,足月AGA 21例。检测血Ghrelin、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein-3,IGFBP-3)以及胰岛素、血糖水平,并在各组间进行比较。结果:30~34周、34+1~37周、37+1~41周3组比较Ghrelin浓度分别为(2.238±0.618)ng/ml(、1.226±0.37)ng/ml(、1.036±0.328)ng/ml,早产儿Ghrelin水平明显高于足月儿(P<0.01),且随着胎龄的增大差距减小;IGF-1分别为(43.214±16.723)ng/ml、(115.579±30.136)ng/ml、(153.292±26.633)ng/ml,IGFBP-3分别为(70.814±22.603)ng/ml、(123.300±28.666)ng/ml、(157.214±38.990)ng/ml,胰岛素分别为(1.032±0.812)μU/ml、(5.534±2.273)μU/ml、(14.654±3.064)μU/ml。IGF-1、IGFBP-3、胰岛素水平早产儿明显低于足月儿(P<0.01),足月SGA的Ghrelin水平明显高于AGA(P<0.01),IGF-1、IGFBP-3、胰岛素水平明显低于AGA(P均<0.01)。各组血糖水平无明显差异(P>0.05)。在SGA和AGA组Ghrelin分别与IGF-1、IGFBP-3及胰岛素呈明显负相关(P<0.01)。结论:SGA新生儿存在胰岛素-IGF轴的损害,IGF-1与胰岛素水平低下,从而使Ghrelin浓度反馈性的升高,以代偿其能量代谢的负平衡。
Objective:To explore the relationship between Ghrelin and insulin-IGF axis and the effect to the growth and development and energy metabolism in newborn. Methods:62 newborn were divided into preterm infant,term infant,SGA infant and AGA infant groups according to the gestational age and birth weight.14 cases were 30~34 weeks gestational age,14 cases were 34+1~37 weeks gestational age,and 34 cases were 37+1~41 weeks gestational age.In term group,13 cases were SGA infants and 21 cases were AGA infants.The concentration of Ghrelin,IGF-1,IGFBP-3,insulin and glucose were measured and compared and correlation analyzed in all the subjects. Results:The concentration of plasma Ghrelin in 30~34 weeks group,34+1~37 weeks group and 37+1~41 weeks group was(2.238±0.618)ng/ml,(1.226±0.37)ng/ml,(1.036±0.328)ng/ml respectively.It was much higher in preterm infant than in the term infant(P〈0.000 1).Furthermore,the higher the gestational age,the smaller the difference.The concentration of IGF-1 was(43.214±16.723) ng/ml,(115.579±30.136)ng/ml,(153.292±26.633)ng/ml respectively.The concentration of IGFBP-3 was(70.814±22.603)ng/ml,(123.300±28.666)ng/ml,(157.214±38.990)ng/ml respectively.The concentration of insulin was(1.032±0.812)μU/ml,(5.534±2.273)μU/ml,(14.654±3.064)μU/ml respectively.The concentration of IGF-1,IGFBP-3 and insulin in preterm infant were lower than in the term infant(P〈0.0001).The concentration of plasma Ghrelin in SGA was higher than in AGA in term infant(1.996±0.294(ng/ml) 1.036±0.328(ng/ml))(P〈0.0001).The concentration of IGF-1,IGFBP-3 and insulin in SGA infant were lower than in AGA infant(IGF-1:68.479±19.489(ng/ml) 153.292±26.633(ng/ml);IGFBP-3:47.662±17.642(ng/ml) 157.214±38.99(ng/ml);insulin:3.898±2.289(μU/ml) 14.654±3.064(μU/ml))(P〈0.000 1).The concentration of glucose were no significant difference in all groups(P〉0.05).The correlation analysis in SGA group and AGA group showed negative correlation between Ghrelin and IGF-1,IGFBP-3 and insulin(in AGA group r=-0.831 1,P〈0.000 1;r=-0.713,P〈0.001;r=-0.688,P〈0.001;in SGA group r=-0.654,P〈0.05;r=-0.737,P〈0.05;r=-0.964,P〈0.000 1). Conclusion:There are insulin-IGF axis lesion in SGA infant.The concentration of IGF-1 and insulin are low,that lead to the concentration of Ghrelin increasing,to compensate the negatively balance.
出处
《中国妇幼保健》
CAS
北大核心
2011年第26期4050-4052,共3页
Maternal and Child Health Care of China