新生儿血瘦素水平的动态变化及意义

Dynamic Changes and Significance of Serum Leptin Concentration during Fetal and Neonate Periods

目的:通过对新生儿期血瘦素水平的动态观察,探讨其在胎儿、新生儿生长发育中的作用。方法:根据胎龄、体重百分位数选择新生儿132例,采用放射免疫法测定血清瘦素、胰岛素、生长激素水平,自动生化仪测定血糖、血脂水平。并对同意随访的35例新生儿进行新生儿血瘦素水平的动态观察。结果:随着胎龄增加,脐血瘦素水平呈上升趋势,且存在性别差异,不同宫内生长状态的足月儿脐血瘦素水平亦不同。脐血瘦素水平与多种因素相关,但仅胎龄、出生体重及体重指数是脐血瘦素水平的独立影响因素。出生后3天新生儿血瘦素水平急剧下降,至28天有所回升。结论:新生儿血瘦素呈动态变化,提示瘦素在胎儿及新生儿生长发育中起着重要的作用。

Objective:To evaluate the role of leptin in growth and development of fetals and neonates though the dynamic observation of the change of neonatal serum leptin.Methods:One hundred and thirty two newborn pairs were enrolled in this study.The leptin,insulin and growth hormone concentrations in newborn cord blood were measured by radioimmunoassay(RIA).Blood sugar,cholesterol(CHOL) and triglyceride(TG) concentrations were measured by auto biochemical analyzer.The serum leptin of 35 newborns from appropriate for gestational age(AGA)infants group and large for gestational age(LGA)infants group were determined around the 3th and 28th day from delivery.Results:The concentrations of leptin in cord blood were gradually increased with the gestational age and the differences between male and female as also outstanding. Leptin levels of AGA group were significantly greater than those of SGA group, but significantly lower than those of LGA group. There was a significant gender difference in leptin levels between male and female infants.Although leptin concentrations were positively correlated with gestational age,birth weight,Ponderal Index (PI),length, head and chest circumference,placental weight,TG,insulin and growth hormone, But only gestational age,birth weight and PI were independent influencing factors with cord blood leptin concentrations.The leptin concentrations of newborns declined rapidly at 3 days of age, and then rose gradually at 28th days.Conclusions:The changes of leptin concentrations in newborns suggest that leptin plays an important role in the regulation of growth and weight gain in fetals and newborns.