血促代谢因子与巨大儿早期生长发育的关系

The relationship between serum betatrophin and early growth of fetal macrosomia

目的探讨血促代谢因子水平与巨大儿早期生长发育的关系。方法采用前瞻性病例对照研究的方法,选取2018年1~6月浙江省瑞安市人民医院妇幼分院产科出生并随访到6月龄的足月巨大儿及产妇纳入巨大儿组,按1:1比例随机选取符合上述要求的足月适于胎龄儿(appropriate for gestational age,AGA)纳入AGA组。分别在婴儿出生和6月龄时应用酶联免疫吸附法检测血清促代谢因子水平,并分析其与婴儿生长发育的关系。结果研究期间共分娩活产新生儿4823例,其中足月巨大儿308例,发生率6.4%;巨大儿组和AGA组各纳入30例,巨大儿组出生和6月龄时血促代谢因子水平均高于AGA组[(1088.3土67.8)ng/L比(929.5±81.0)ng/L,(l 057.1±114.2)ng/L比(976.4±76.6)ng/L],差异有统计学意义(P<O.Ol);6月龄时巨大儿组和AGA组的超重发生率分别为26.7%(8/30)和6.7%(2/30),差异有统计学意义(P<0.05),两组超重婴儿血促代谢因子水平均高于非超重婴儿,差异有统计学意义(P<0.001)。6月龄时婴儿血促代谢因子水平与出生和6月龄时的体重、身长、体重/身长Z评分、血甘油三酯水平,以及脐血促代谢因子水平成正相关(P<0.001);与性别、喂养方式、血脂其他成分、脐血和母血血糖和胰岛素、母血促代谢因子水平无关(P>0.05)。结论血促代谢因子参与婴儿生长发育调节,与婴儿发生超重相关。

Objective To study the relationship between serum betatrophin and early growth of macrosomia.Method Full-term macrosomia bom in the Maternity and Children's Branch of Ruian People's Hospital of Zhejiang Province from January to June 2018 followed up to 6 months and their mother were enrolled in the prospective case-control study as the fetal macrosomia group.The full-term infants appropriate for gestational age,who met all the above requirements were randomly enrolled in the AGA group in a 1:1 ratio.Enzyme linked immunosorbent assay(ELISA)was used to detect the level of blood betatrophin at birth and 6 months respectively,and the relationship between serum betatrophin level and the growth and development of infants was analyzed.Result A total of 4823 live births were delivered during the study period,308 of them were full-term macrosomia,the incidence was 6.4%.30 cases were included in the macrosomia group and the AGA group,respectively.The level of blood betatrophin at birth and 6 months in the macrosomia group were higher than that in the AGA Group[(1088.3±67.8)ng/L vs.(929.5±81.0)ng/L,(1057.1±114.2)ng/L vs.(976.4±76.6)ng/L],and the differences were statistically significant(P<0.01).The incidence of overweight was 26.7%(8/30)in the macrosomia group and 6.7%(2/30)in AGA group at 6 months of age,the difference was statistically significant(P<0.05).The level of blood betatrophin in overweight infants was statistically significantly higher than that in nonoverweight infants(P<0.001).There was a positive correlation(P<0.001)between the level of blood betatrophin at the age of 6 months and the weight,body length,Z-score of weight/body length,triglyceride level at birth and the age of 6 months,and the level of umbilical blood betatrophin.But it was not correlated to gender,feeding pattern,other components of blood lipid,blood glucose and insulin in the cord blood and mother's blood,and the level of blood betatrophin in mother's blood(P>0.05).Conclusion The betatrophin is involved in the regulation of infant growth and development,which is associated with the occurrence of overweight.