脐静脉血清IGF-2水平与巨大儿发生的关系

Association between insulin-like growth factor-2 in cord vein and macrosomia

目的:探讨脐静脉血清胰岛素样生长因子-2(IGF-2)水平与巨大儿(MAC)的关系。方法:选择2018年1月至2019年12月出生于温州医科大学附属第一医院的足月MAC和正常出生体质量儿(NBW)分别61例和60例。检测脐静脉血血清IGF-2水平,并采用Pearson或Spearman相关分析法分析其与新生儿生长发育指标的相关性。结果:MAC和NBW组的脐静脉血清IGF-2水平分别为(221.92±29.97)ng/mL和(169.69±14.53)ng/mL,2组间差异有统计学意义(P<0.001);在MAC和NBW组中,母亲合并妊娠期糖尿病(GDM)新生儿的脐静脉血清IGF-2水平高于母亲无GDM者(GDM-MAC组vs.nGDM-MAC组为229.71 ng/mL vs.214.18 ng/mL,P=0.046;GDM-NBW组vs.nGDM-NBW组为175.69 ng/mL vs.161.48 ng/mL,P<0.001)。相关性分析显示脐静脉血清IGF-2水平与新生儿出生体质量、身长和重量指数呈正相关(r=0.678、0.566、0.600,均P<0.001)。IGF-2水平也与胎龄相关(r=0.273,P=0.002),但与新生儿性别、母亲年龄、高学历和初产无关(P>0.05)。结论:新生儿脐静脉血清IGF-2水平受母亲GDM和胎龄影响;IGF-2可反映胎儿生长发育状况,高水平IGF-2与巨大儿发生有关。

Objective:To evaluate the serum concentration of insulin-like growth factor-2(IGF-2)in cord vein and to assess its relationship with macrosomia.Methods:Totally 61 macrosomia(MAC)and 60 normal birth weight(NBW)term infants,born in the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were enrolled in this study.The serum IGF-2 concentration in cord vein was detected.Pearson or Spearman correlation analysis was used to assess the relationship between IGF-2 and growth parameters of the newborn.Results:The serum concentrations of IGF-2 in cord vein were(221.92±29.97)ng/mL and(169.69±14.53)ng/mL in MAC group and NBW group respectively,with significant difference(P<0.001).Newborns of gestational diabetes mellitus(GDM)versus euglycemic mothers had an elevated level of cord vein IGF-2(GDM-MAC vs.nGDM-MAC=229.71 ng/mL vs.214.18 ng/mL,P=0.046;GDM-NBW vs.nGDM-NBW=175.69 ng/mL vs.161.48 ng/mL,P<0.001).Correlation analysis showed that cord vein IGF-2 was positively related to birth weight,birth length,and ponderal index(PI)(r=0.678,0.566,0.600,P<0.001).The concentration of IGF-2 was also related to gestational age(r=0.273,P=0.002).However,there was no significant correlation between IGF-2 level and newborn gender,maternal age,maternal higher education or primiparity(P>0.05).Conclusion:IGF-2 level in cord vein of newborn is affected by maternal gestational diabetes mellitus and gestational age.Meanwhile,IGF-2 is correlated to fetal growth and its high level may play an important role in the occurrence of macrosomia.