孕妇及其新生儿端粒长度的影响因素分析

Influence factors for maternal and neonatal telomere length

目的:全面评估孕期各种因素对孕妇及新生儿端粒长度的影响,为探讨端粒在疾病发生和发展中的作用机制提供依据。方法:2015年3月—2016年2月在南京大学医学院附属鼓楼医院出生444例新生儿,对其母亲进行问卷调查、体格检查和临床相关指标检测,并采集新生儿脐静脉血及其配对的母体外周血样本。采用定量PCR法测量各样本的相对端粒长度。然后采用配对t检验比较母儿端粒长度,采用一般线性模型分析新生儿与母亲端粒长度等连续性变量之间的相关性,采用方差分析法和t检验分析不同亚组间相对端粒长度的差异。结果:新生儿相对端粒长度(均数为0.358)明显大于母亲相对端粒长度(均数为0.309,P<0.001),未发现母儿端粒长度之间有明显的相关性(r2=0.004,P=0.174)。母亲受教育程度越高,新生儿相对端粒长度越长(P=0.022);而孕周、分娩方式、新生儿性别和出生体质量均与母婴端粒长度无明显相关性。孕期摄入奶制品较多,母体相对端粒长度较短(P=0.048);孕期摄入蔬菜水果、肉制品、动物内脏、鱼虾、豆制品、煎烤及腌制食品、叶酸及多种维生素不同组之间,新生儿和母体的相对端粒长度差异均无统计学意义;孕期饮用咖啡,新生儿相对端粒长度较短(P=0.011);孕期二手烟暴露、饮酒及饮茶情况对母体和新生儿相对端粒长度均无明显影响;孕期经常参加体育锻炼的母体相对端粒长度较不锻炼或很少锻炼者长(P=0.01),新生儿相对端粒长度未见明显差异(P=0.187)。结论:受教育程度以及孕期摄入奶制品、饮用咖啡和参加体育锻炼可能影响孕妇或新生儿的端粒长度,为进一步揭示端粒在疾病发生发展中的作用提供了线索。

Objective：To comprehensively investigate the environmental factors influencing maternal and neonatal telomere length at birth,and to provide evidences for exploring the role of telomere in pathogenesis and development of diseases.Methods：From March 2015 to February 2016,444 newborns and their mothers in Nanjing Drum Tower Hospital were enrolled.Questionnaire surveys,physical examinations and clinical assessments were conducted in pregnant women,and the maternal peripheral blood samples as well as their matching umbilical venous blood samples were collected.The relative telomere length was measured by quantitative PCR method.The maternal telomere length and neonatal telomere length were compared by paired t test.The telomere length between different subgroups was compared by variance analysis and t test.The correlation between maternal telomere length and neonatal telomere length as well as the correlations of telomere length with other continuous variables were analyzed by using general linear model.Results：The overall telomere length of cord blood was significantly longer than that of maternal blood（0.358 vs 0.309,P0.001）,but there was no significant correlation between telomere length of maternal blood and telomere length of cord blood（r2=0.004,P=0.174）.There was a significant positive correlation between maternal education level and the telomere length of cord blood（P=0.022）.There were no obvious correlations of maternal and neonatal telomere length with gestational age,delivery mode,newborn sex and birth weight.The more dairy intake during pregnancy,the shorter maternal telomere length（P=0.048）.There were no significant differences of maternal and neonatal telomere length among different subgroups intaking fruits,vegetables,meat,animal offal,fish,shrimp,bean products,baked and preserved food,folic acid and vitamins.Coffee drinking during pregnancy was significantly associated with shorter neonatal telomere length（P=0.011）.Second hand smoke exposure,alcohol consumption and tea drinking during pregnancy were not significantly associated with maternal and neonatal telomere lengths.Longer maternal telomere length was observed in those taking physical exercise during pregnancy（P=0.01）,but no significant difference was observed in neonatal telomere length（P=0.187）.Conclusions：Various environment exposures such as education level,intake of dairy products,coffee drinking and physical exercise during pregnancy have significant effects on maternal and neonatal telomere length.This study provides valuable clues for further revealing the role of telomere in diseases.