脐血瘦素、脂联素及IGF-Ⅰ与胎儿生长发育的初步研究

Initial research of cord blood leptin,adiponectin and IGF-Ⅰwith fetus growth and development

目的旨在揭示脐血脂联素、瘦素及胰岛素样生长因子-I(IGF-Ⅰ)与胎儿生长发育的关系,探讨其在胎儿生长发育方面的相互作用及临床意义。方法采用放射免疫法测定86例新生儿脐血脂联素、瘦素、IGF-Ⅰ水平,根据胎龄及出生体质量百分位数的关系分为:SGA组16例,AGA组41例及LGA组29例,同时测量新生儿的出生体质量、身长、头围、足长、胎盘重量并计算体重指数(BMI)。结果脐血瘦素、脂联素及IGF-Ⅰ水平均LGA组>AGA组>SGA组。脐血脂联素水平与出生体质量、胎盘重量、BMI水平均呈正相关(P均<0.05)。脐血瘦素及IGF-Ⅰ水平分别与新生儿出生体质量、身长、头围、足长、BMI及胎盘重量呈显著正相关(P<0.01),脐血瘦素与脂联素、IGF-Ⅰ水平亦呈显著正相关(P<0.01)。脐血瘦素、脂联素水平与新生儿性别及分娩方式间均差异无统计学意义(P>0.05);脐血IGF-Ⅰ水平与新生儿性别差异无统计学意义(P>0.05),与新生儿分娩方式差异有统计学意义(P<0.05)。结论脐血瘦素、脂联素、IGF-Ⅰ在调节胎儿生长发育方面起着重要作用,参与胎儿的生长发育过程,可作为评价胎儿生长发育及营养状态的临床指标之一。脐血瘦素、IGF-Ⅰ水平异常可能是引起胎儿宫内生长迟缓和巨大儿发生的原因之一。

Objective In order to reveal the relationship between cord blood leptin, adiponectin and IGF-Ⅰ and the fetus growth and development,and discuss the interaction and clinical significance on fetus growth and development. Methods The levels of cord blood leptin, adiponectin,IGF-Ⅰ in 86 newborns were examined by radio immunoassay, according to gestation age and birth weight percentile relation were divided into the SGA group （ n = 16 ）, the AGA group （n = 41 ） i the LGA group （ n = 29 ）, meanwhile measure neonatal birth weight, body lengt h, head circumference, foot length, placental weight and compute body mass index, results undertake dependability analyze. Results The levels of cord blood leptin,adiponectin and IGF-Ⅰ all LGA group〉AGA group〉SGA group. The level of cord blood adiponectin was positively correlated with birth weight,placental weight and body mass index（P〈0. 05）. Cord blood Leptin and IGF- Ⅰ concentrations separate were positively correlated with their birth weight, body length, head circumference, foot length, placental weight and body mass index （P 〈0. 01）, Leptin were positively correlated with adiponectin and IGF-Ⅰ （P 〈0.01）. The levels of cord blood leptin and adiponectin had no statistical significance with neonatal sexuality and deliver style（P 〉0.05） ;the levels of cord blood IGF- Ⅰ had no significantly different with neonatal sexuality（P 〉 0. 05）, statistical significance with deliver style（P〈0. 05）. Conclusion Cord blood Leptin,adiponectin and IGF- Ⅰ played an important part in adjust fetus growth and development,participate in the process of fetus growth and development, could be regarded as one of the clinical indexes to evaluate fetus growth and development or nutrient. The abnormal level of cord blood Leptin, IGF-Ⅰ might be one of the reasons to cause intrauterine growth retardation and large for date infant occurrence.