新生儿脐带血鸢尾素水平与出生体重及宫内生长受限的关系

Relationship between Neonatal Umbilical Cord Blood Irisin Level and Birth Weight and Intrauterine Growth Restriction

目的本实验将检测不同出生体重及子宫内生长受限(IURG)新生儿脐带血中鸢尾素(Irisin)的含量,并探究Irisin与新生儿体重、胎龄和其他因素的关系。方法本研究对2014年5月~2016年5月在笔者医院诞生的新生儿进行横断面研究。把新生儿按照体重分为小于胎龄儿(SGA)、大于胎龄儿(LGA)、适于胎龄儿(AGA),同时收集IUGR的新生儿。检测4组新生儿脐带血中Irisin的水平。结果本实验一共纳入110例新生儿,其中SGA与AGA各30例,IUGR与LGA各25例。SGA组中新生儿的平均胎龄小于其他3组,SGA与IUGR组中新生儿的平均出生体重小于其他两组(P=0.000)。SGA与IUGR组中平均Irisin水平[54.4(45.6~66.7)ng/ml,53.7(40.3~62.4)ng/ml]显著低于LGA组[67.7(53.8~78.1)ng/ml]与AGA组[64.7(53.6~71.2)ng/ml](P=0.000)。LGA组中平均胰岛素水平[7.54(0.83~58.96)m IU/ml]显著高于AGA组[38.00(34.40~39.30)m IU/ml]与IUGR组[3.86(0.49~16.15)]及SGA组[(4.19(0.62~14.42)m IU/ml](P=0.000)。本研究通过相关性分析发现新生儿脐带血Irisin水平与新生儿胎龄(r=0.22,P<0.01)、胎儿体重(r=0.17,P<0.01)、孕妇年龄(r=-0.12,P=0.021)呈正相关。但只有在LGA组中新生儿脐带血Irisin水平与胰岛素水平(r=0.41,P=0.042)呈正相关。多因素线性回归分析发现,SGA(β=-0.14,P=0.02)与胎儿体重(β=0.05,P=0.008)是新生儿脐带血Irisin水平的独立危险因素。结论新生儿脐带血Irisin水平与出生体重呈正相关。SGA与IURG组新生儿的Irisin水平明显低于AGA与LGA组新生儿,但Irisin水平在SGA与IURG组间及AGA与LGA组间差异无统计学意义。且只有LGA组新生儿中Irisin水平与胰岛素水平呈正相关。Irisin水平在患有先兆子痫的孕妇所产的新生儿中明显低于正常孕妇。

Objective SGA and IURG fetuses are important risk factors for metabolic disease in adulthood, but the mechanism is not clear. In this study, Irisin levels in umbilical cord blood of different birth weight and IURG neonates were measured and the relationship between Irisin and neonatal weight, gestational age and other factors was explored.Methods This study was conducted in the cross-sectional study of neonates born in our hospital from 2014 to 2016. Newborns were divided into small-for-gestational age （SGA）, greater-than-gestational age （LGA）, gestational age （AGA） and newborns with intrauterine growth restriction （IUGR）. The levels of irisin in umbilical cord blood of 4 newborns were detected.Results In this study, there were a total of 110 cases of newborns. The mean gestational age and mean birth weight of newborns in the SGA group was lower than that in the other three groups（P=0.000）. The mean Irisin levels in the SGA and IUGR groups[54.4（45.6-66.7）ng/ml, 53.7（40.3-62.4）ng/ml] were significantly lower than those in the AGA group[67.7（53.8-78.1）ng/ml,64.7（53.6-71.2）ng/ml]（P=0.000）. The mean insulin levels in the LGA group[7.54（0.83-58.96）mIU/ml] were significantly higher than those in the AGA group[38.00（34.40-39.30）mIU/ml] and IUGR[3.86（0.49-16.15）] and SGA[4.19（0.62-14.42）mIU/ml] （P=0.000）. In the present study, the correlation analysis showed that Irisin level in neonatal umbilical cord blood was significantly correlated with neonatal gestational age （r=0.22,P〈0.01）, fetal weight （r=0.17,P〈0.01） and maternal age （r=-0.12, P=0.021）. However, only in the LGA group, the level of Irisin in cord blood of neonates was positively correlated with insulin level （r=0.41, P=0.042）. Multivariate linear regression analysis revealed that SGA （β=-0.14, P=0.02） and fetal weight （β=0.05, P=0.008） were independent risk factors for neonatal umbilical cord blood Irisin levels.Conclusion There was a positive correlation between irisin level and neonatal umbilical cord blood birth weight. The levels of irisin in the neonates of the SGA and IURG groups were significantly lower than those of the AGA and LGA groups, but irisin levels did not differ between the SGA and IURG groups and between AGA and LGA groups. And irisin levels in the LGA group were positively correlated with insulin levels. Our results also reveal that singleton infants of mothers with preeclampsia had lower cord blood irisin levels compared to infants of mothers without preeclampsia.