多囊卵巢综合征母亲的新生儿脂肪代谢指标与脐带血雄激素水平的关系

Relationship of the fat metabolic parameters and androgen level of umbilical cord blood in newborns of mothers with polycystic ovary syndrome

目的评估多囊卵巢综合征(PCOS)母亲所生新生儿的脂肪代谢指标与脐带血雄激素水平的关系。方法选取55例PCOS母亲及其新生儿的临床资料(PCOS组),40例体质指数(BMI)与PCOS组匹配的健康母亲及其新生儿资料为对照组,测量并比较PCOS母亲的身高、体质量、腰围、臀围、分娩后新生儿的身长和头围。分娩后立即收集脐动脉-静脉混合脐带血,检测血脂指标、血清胰岛素和睾酮水平。用多元线性回归分析新生儿胆固醇(TC)和睾酮水平的影响因素。结果 PCOS组新生儿的出生体质量、头围、TC、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和三酰甘油(TG)水平低于对照组,出生身高和睾酮高于对照组(P<0.05)。PCOS组母亲的腰臀比(WHR)、BMI、TC、HDL-C和睾酮水平高于对照组(P<0.05)。PCOS母亲的胰岛素、TC、TG水平是新生儿TC的影响因素,PCOS母亲的TC、TG和睾酮水平是新生儿睾酮水平的影响因素。结论 PCOS母亲可能会影响胎儿的出生体质量、头围、身高和脐血血脂代谢,可能与在胎儿期暴露于较高的睾酮水平有关。

Objective To assess the relationship between fat metabolic parameters and androgen concentration in the cord blood of newborns of mothers with polycystic ovary syndrome （PCOS）. Methods This cross-sectional study included PCOS women （n=55） and neonatal, and 40 cases with matched body mass index （BMI） were used as control. The clinical data including height, body mass, waist circumference, hip circumference of PCOS group, and length and head circumference in newborns after delivery were measured and compared. Blood lipid level, serum insulin and testosterone level were detected using umbilical artery-vein mixed cord blood after delivery. Regression analysis was used to analyze the influence factors of neonatal cholesterol and testosterone levels. Results The neonatal birth weight, head circumference, cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride level were significantly lower, birth height and testosterone level were significantly higher, in PCOS group than those of control group （P 〈 0.05）. Values of waist to hip ratio, BMI, cholesterol, high density lipoprotein cholesterol and testosterone levels were significantly higher in PCOS group than those of control group （P 〈 0.05）. The insulin, cholesterol and triglyceride levels of PCOS mother were risk factors for neonatal cholesterol level（P 〈 0.05）. The cholesterol, triglyceride and free testosterone levels of PCOS mother were risk factors for increased neonatal free testosterone （P 〈 0.05）. Conclusion Mother with PCOS may affect fetal birth weight, head circumference and cord blood lipid metabolism, which may be related with the elevated level of testosterone during the fetal period.