母乳中胰岛素样生长因子1水平对新生儿生长发育的影响

Influence of IGF-1 level in breast milk on growth and development of neonates

目的 动态观察人类母乳中胰岛素样生长因子 1(IGF 1)在初乳及成熟乳中的变化及其与泌乳量的关系 ;探讨母乳中IGF 1水平对新生儿生长发育的影响。方法 监测 38名足月新生儿生后 6周身长、体重、头围的增长及其母亲体重指数。采用双抗放射免疫法测定初乳 (生后 3～ 5d)和成熟乳 (生后 4 2d)中IGF 1的浓度并测量同日母乳量 ,测量新生儿生后 3～ 5d血清IGF 1浓度 ,并分析两者之间的关系。结果 (1)初乳中IGF 1浓度 [(6 3± 1 6 ) μg/L]显著高于成熟乳 [(4 7± 2 1) μg/L],差异有显著意义 (t=3 2 32 ,P <0 0 5 )。 (2 )初乳和成熟乳中IGF 1的浓度 [分别为 (6 3± 1 6 ) μg/L ,(4 7± 2 1) μg/L]均与同日母乳分泌量 [分别为 (380± 114 )ml/d ,(783± 199)ml/d]呈正相关 (r分别为 0 6 17,0 793) ;乳量绝对不足的母亲初乳中IGF 1浓度 [(4 1± 1 5 ) μg/L]明显低于能维持母乳喂养者 [(6 3± 1 6 ) μg/L],差异有显著意义 (t=4 4 5 4 ,P <0 0 0 1)。 (3)与新生儿体重、头围增长相关的因素按相关性大小依次为成熟乳量、初乳中IGF 1的浓度、新生儿生后早期血清IGF 1水平以及母亲哺乳期的体重指数。结论 初乳中足够的IGF 1浓度是启动泌乳并使之得以维持的重要条件 ,乳腺分泌的IGF 1可能通过促进?

Objective To detect IGF 1 concentrations in the colostrums and mature milk, to explore their relationships with the corresponding lactating volumes and, to understand the effect of IGF 1 in human milk on the growth and development of neonates Methods The indexes of the body length, weight and head circumference in 38 term neonates were recorded and followed up for 6 weeks after birth The BMI of mothers was calculated before the pregnancy, after the delivery and on the day of perinatal health examination IGF 1 concentration was detected in the colostrum and neonate′s serum at the third to the fifth day after birth, and in the mature milk at the sixth week by double antibody radioimmunoassay along with measuring corresponding daily lactating volume Results (1) IGF 1 concentration in the colostrum[(6 3±1 6)μg/L]was more than that in the mature milk [(4 7±2 1) μg/L, t =3 232, P <0 05] (2) Both concentrations of IGF 1 in the colostrum and mature milk (6 3±1 6) μg/L and (4 7±2 1) μg/L, respectively) were positively correlated with the corresponding lactating volume [(380±114) ml/d and (783±199) ml/d, r =0 617 and 0 793, respectively] Mothers without enough milk production showed significantly lower concentration of IGF 1 in the colostrum[(4 1±1 5) μg/L]than mothers persisting the breast feeding[(6 3±1 6) μg/L, t =4 454, P <0 01] (3) The major influence factors of the development of the body weight and head circumference were the lactating volume of the mature milk, IGF 1 concentration in colostrum, neonate′s serum concentration of IGF 1 and mother′s BMI of lactation period Conclusions Enough IGF 1 level in the colostrum may be an important precondition for star up and maintenance of lactation IGF 1 secreted from the breast may participate the modulation of neonate′s nutritional metabolism and growth possibly by facilitating neonate′s gastrointestinal development and by benefiting the absorption and utilization of nourishment.