小于胎龄儿血nesfatin-1水平及其与生长发育的关系

Relationship of Plasma Nesfatin-1 with Growth and Development of Small Gestational Age Infant

目的探讨nesfatin-1与新生儿能量代谢的关系。方法 113例新生儿分为早产儿53例、足月儿60例。足月儿分为适于胎龄(AGA)儿,32例、小于胎龄(SGA)儿28例。检测其空腹血浆nesfatin-1、生长激素释放肽(ghrelin)、胰岛素样生长因子-1(IGF-1)、胰岛素和血糖水平,并进行比较。结果 SGA组空腹血浆nesfatin-1、ghrelin、胰岛素水平及胰岛素抵抗指数(HOMA-IR)均高于AGA组(P=0.035 8,0.016 3,0.000 1,0.005 1);IGF-1、胰岛素敏感指数(HOMA-ISI)低于AGA组(P=0.033 0,0.000 1)。与出生0 d相比,出生7 d 2组nesfatin-1水平均明显降低(P<0.000 1),尤其是SGA组下降幅度更大。然后逐渐上升,到第28天,AGA组上升至出生时水平(P=0.284 8),但SGA组仍低于出生0 d的水平(P<0.000 1)。出生0 d,nesfatin-1水平在SGA组高于AGA组(P=0.035 8),但出生7 d及28 d,SGA组低于AGA组(P=0.000 2,0.048 8)。SGA组nesfatin-1与经口摄入热卡呈负相关(r=-0.446,P=0.017 0),与HOMA-ISI亦呈负相关(r=-0.398,P=0.036 0),与HOMA-IR呈正相关(r=0.43,P=0.023 0)。结论 nesfatin-1参与调控SGA儿摄食及能量代谢。nesfatin-1与SGA儿胰岛素敏感性有一定关系。

Objective To explore the relationship between nesfatin - 1 and energy homeostasis in newborns. Methods One hundred and thirteen newborns were divided into 2 groups （preterm infants, n = 53 ;term infants, n = 60）. The term infants were divided into the following groups ： appropriate for gestational age （AGA） group （ n = 32） and small for gestational age （SGA） group （ n = 28 ）. The levels of fasting plasma nesfatin - 1, ghrelin, insulin - like growth factor - 1 （ IGF - 1 ） , insulin and glucose were measured. Results The fasting plasma con- centrations of nesfatin- 1, ghrelin and insulin and the homeostasis model assessment insulin resistance index （HOMA- IR） were higher in SGA infants than those in AGA infants （ P = 0.035 8,0. 016 3,0. 000 1 and 0. 005 1, respectively）. The IGF - 1 level and homeostasis model assessment insulin secitive index （HOMA -ISI） were lower in SGA infants than those in AGA infants （P =0. 033 0 and 0. 000 1 ,respectively）. Compared with postnatal day 0 （PNDO） ,fasting plasma concentration of nesfatin - 1 was lower on PND7 in SGA （P 〈0. 000 1 ） and AGA （P =0. 009 4） infants. Then,the level of nesfatin - 1 increased gradually,and it was lower on PND28 than PND0 in SGA infants （P 〈 0.000 1 ）. Compared with AGA infants,the concentration of nesfatin - 1 in SGA infants was higher on PNDO （ P = 0.035 8 ） and lower on PND7 （ P = 0. 000 2 ） and PND28 （.P = 0.048 8 ）. The correlation analysis for SGA infants showed a negtive correlation between nesfatin - 1 and oral calorie intake （ r = -0. 446, P = 0. 017 0） and HOMA - ISl （ r = -0. 398, P = 0. 036 0 ）. There was positive correlation between nesfatin - 1 and HOMA - IR （ r = 0. 430,P =0. 023 0）. Conclusions Nesfatin - 1 is involved in the physiological regulation of food intake and energy homeostasis in newborns. There may be a certain relationship between nesfatin - 1 and insulin sensitivity in SGA infants.