脐血瘦素水平与胎儿宫内生长发育相关性研究

Leptin Concentration in Cord Blood Correlates With Intrauterine Growth

目的 探讨脐血瘦素来源及其在胎儿宫内发育成熟中作用。 方法 采用放免检测孕母外周静脉血与新生儿脐血瘦素水平 ,采用 Ponderal指数 [PI=10 0×体重 (g) /身长 (cm) 3]估测新生儿营养状态 ,采用 weststrate公式 [F% =0 .8848× SFT4+ 0 .0 2 2 ]估测新生儿体脂含量。 结果 6 5例新生儿脐血瘦素水平 (x± s)为 (11± 4) ng/ ml,30例孕母外周血瘦素水平为 (2 0± 7) ng/ ml;脐血瘦素水平与孕母外周血瘦素水平无显著相关 (r=0 .11,P>0 .0 5 ) ,与胎盘重量、新生儿体脂含量 (% )显著相关 (分别为 0 .71、0 .2 8,P<0 .0 5 )。大于胎龄儿 (L GA)脐血瘦素水平显著高于适于胎龄儿 (P=0 .0 14) ;小于胎龄儿 (SGA)脐血瘦素水平显著低于适于胎龄儿 (P=0 .0 0 72 ) ;脐血瘦素水平与新生儿Ponderal指数 (PI)显著相关 (r=0 .6 2 4,P<0 .0 1)。 结论 脐血瘦素反映胎儿宫内生长状况 ;胎盘可能是脐血瘦素重要来源 。

Objective To determine the origin of cord serum leptin and its relationship with neonatal anthropometry. Methods Sixty five women and their babies took part in this prospective cohort study. Blood was taken from the women just before delivery and from the umbilical cord of their babies at delivery. Serum leptin was measured by radio immunoassay. Neonatal anthropometric measurements were recorded within 48 hours after delivery. Linear regression analysis was used to explore the relationship between serum leptin concentrations and anthropometric measures and multiple regression analysis then applied to determine which variables remained independently associated with leptin. Results The leptin concentration ( ±s )in maternal serum was (19.93±7.21) ng/mL and in cord blood was (10.50±3.45) ng/mL. Cord leptin levels correlated with placental weight, neonatal birthweight, skinfold thickness and ponderal index but not with maternal leptin levels. The correlation with Placental weight and neonatal birthweight remained significant after multiple regression analysis. Conclusions Relatively big serum leptin concentration gradient between mother and umbilical vessels indicates that placenta might play an important role in leptin production. We hypothesize that leptin might play an important role during pregnancy and fetal development.