脐血AFABP、瘦素与非妊娠期糖尿病巨大儿发生的相关性分析

The correlation of adipocyte fatty acid binding protein and leptin in umbilical cord blood with non-GDM macrosomia

目的:探讨脐血脂肪细胞型脂肪酸结合蛋白(AFABP)、瘦素与非妊娠期糖尿病(GDM)巨大儿发生的关联性。方法:采用病例对照研究设计,在温州医科大学附属第二医院育英儿童医院产科选择46例非GDM巨大儿(巨大儿组)和46例正常出生体质量儿(对照组),用自行设计的调查表收集产妇和新生儿的基本信息。分别采用酶联免疫法和放射免疫法测定脐血AFABP和瘦素浓度,运用Logistic回归分析非GDM巨大儿发生的影响因素。结果:脐血中AFABP浓度在2组间差异无统计学意义(P>0.05),但脐血瘦素浓度在巨大儿组高于对照组(P<0.05)。分层分析发现,在高孕周层及孕期增重过多层,巨大儿组脐血AFABP浓度均低于对照组(均P<0.05);在男性胎儿层、低孕周(孕周≤39)层及孕期增重正常层,巨大儿组脐血瘦素浓度均高于对照组(均P<0.05)。多因素Logistic回归分析表明,脐血低浓度的AFABP会增加非GDM巨大儿的发生风险(OR=3.792,95%CI:1.266~11.359,P<0.05),且与胎儿性别、孕周、孕期增重共同影响非GDM巨大儿的发生。结论:脐血中低浓度的AFABP可能会增加非GDM巨大儿的发生风险。

Objective:To investigate the correlation of AFABP and leptin in umbilical cord blood with non-GDM macrosomia.Methods:A case-control study was performed.Newborns were selected,with 46 macrosomia and 46 normal-birth-weight,in the Obstetric Department of the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University.A self-designed questionnaire was used to collect maternal and fetal baseline information.The umbilical cord blood concentration of AFABP and leptin was measured by ELISA and RIA,respectively.Logistic regression analysis was used to analyze the influencing factors of non-GDM macrosomia.Results:There was no difference in cord blood AFABP concentration between the two groups,and the leptin concentration in macrosomia cord blood was significantly higher than that of control group(P<0.05).Stratified analysis found that in the higher gestational layer(gestational age>39)and excessive gestational weight gain layer,AFABP concentration in macrosomia cord blood was significantly lower than that of the control group(P<0.05);the leptin concentration in macrosomia cord blood was significantly higher than that of the control group in the male fetal layer,lower gestational age layer(gestational age≤39)and normal gestational weight gain layer(P<0.05).Multivariable logistic regression analysis showed that the lower AFABP concentration in umbilical cord blood could increase the risk of non-GDM macrosomia(OR=3.792,95%CI:1.266~11.359,P<0.05),the occurrence of non-GDM macrosomia was also influenced by fetal gender,gestational age and gestational weight gain.Conclusion:Lower AFABP concentration in umbilical cord blood may increase the risk of non-GDM macrosomia.Further studies are required to elucidate its molecular mechanism.