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目的探讨脂联素、瘦素及胰岛素样生长因子-Ⅰ(IGF-Ⅰ)在胎儿生长发育中的作用。方法选择2006年10月-2007年10月在本院产科出生的新生儿86例。胎龄31~42周;男57例,女29例。根据不同出生体质量分为小于胎龄儿(SGA)组(16例),适于胎龄儿(AGA)组(41例)及大于胎龄儿(LGA)组(29例)。胎儿娩出后立即断脐留脐血20 mL,采用放射免疫分析法测定血清脂联素、瘦素及IGF-Ⅰ水平,同时检测其血脂水平,测量新生儿生长参数,计算体质量指数(BMI)。结果1.新生儿脐血瘦素、脂联素及IGF-Ⅰ水平无显著性别差异。2.脐血瘦素水平在SGA、AGA、LGA3组间有显著差异(P<0.001),LGA组显著高于AGA及SAG组(P<0.01,0.001);脐血瘦素水平与体质量、胎龄、头围、身长、足长及胎盘质量均呈显著正相关(Pa<0.01)。3.脐血脂联素水平与出生体质量、头围、足长、BMI水平均呈显著正相关(Pa<0.05)。脐血脂联素水平在SGA、AGA、LGA3组间有显著差异(P<0.001),LGA组高于AGA及SAG组(Pa<0.01)。4.LGA组脐血IGF-Ⅰ水平显著高于AGA及SAG组,3组间有明显差异(P<0.001);脐血IGF-Ⅰ水平与体质量、头围、身长、足长及胎盘质量均呈显著正相关(Pa<0.01)。5.脐血瘦素与脂联素、IGF-Ⅰ水平呈显著正相关(Pa<0.01),脐血脂联素与IGF-Ⅰ水平无明显相关关系(P>0.05)。6.SGA、AGA、LGA3组血脂水平比较无显著差异(Pa>0.05)。脐血IGF-Ⅰ水平与三酰甘油水平呈明显负相关(P<0.05),脐血脂联素、瘦素水平与血脂各指标间均无明显相关性(Pa>0.05)。结论瘦素与脂联素、IGF-Ⅰ在胎儿宫内生长和发育过程中起重要的调节作用,可作为评价胎儿生长发育及营养状态的临床指标之一。
Objective To investigate the role of adiponectin, leptin and insulin-like growth factor-Ⅰ (IGF-Ⅰ) in fetal growth and development. Methods Totally 86 neonates were born in our obstetrics department from October 2006 to October 2007. Gestational age 31 to 42 weeks; 57 males and 29 females. According to the different birth weight, they were divided into SGA group (16 cases), AGA group (41 cases) and LGA group (29 cases). Serum levels of adiponectin, leptin and IGF-Ⅰ were determined by radioimmunoassay. The serum lipid level was measured at the same time. The newborn growth parameters were measured. The body mass index (BMI) . Results 1. Neonatal cord blood leptin, adiponectin and IGF-Ⅰ levels of no significant gender differences. Serum leptin levels were significantly different between SGA, AGA and LGA3 groups (P <0.001), LGA group was significantly higher than AGA and SAG groups (P <0.01, 0.001) There was a significant positive correlation between gestational age, head circumference, body length, foot length and placenta quality (Pa <0.01). Cord blood adiponectin levels and birth weight, head circumference, foot length, BMI levels were significantly positive correlation (Pa <0.05). Serum cord blood adiponectin levels were significantly different between SGA, AGA and LGA3 groups (P <0.001), while those in LGA group were higher than those of AGA and SAG groups (Pa0.01). The level of IGF-Ⅰ in umbilical cord blood of LGA group was significantly higher than that of AGA and SAG group (P <0.001). The level of IGF-Ⅰ in umbilical cord blood was positively correlated with body weight, head circumference, body length, There was a significant positive correlation (Pa <0.01). There was a significant positive correlation between cord blood leptin and adiponectin and IGF-Ⅰlevel (Pa <0.01). There was no significant correlation between cord blood adiponectin and IGF-Ⅰlevel (P> 0.05). There was no significant difference in serum lipids between SGA, AGA and LGA3 groups (Pa> 0.05). The level of IGF-Ⅰ in umbilical cord blood was negatively correlated with triglyceride (P <0.05). There was no significant correlation between adiponectin, leptin levels and serum lipids (Pa> 0.05). Conclusions Leptin, adiponectin and IGF-Ⅰ play an important role in the growth and development of the fetus and may be used as one of the clinical indexes to evaluate the growth and nutritional status of the fetus.