论文部分内容阅读
目的通过比较小于胎龄儿(SGA)和足月正常新生儿脐血Ghrelin水平的变化,分析脐血Ghrelin与新生儿出生体重、身长、头围、BMI和胎盘重量、胎盘体积的关系,以及脐血Ghrelin水平与IGF-1、胰岛素、胰岛素敏感性和血糖的关系。探讨脐血Ghrelin水平与胎儿发育和代谢轴之间,尤其是Ghrelin与IGF-1的相互关系。方法2006年12月至2007年3月选择中山大学附属一院新生儿78例,SGA组22例为观察组,足月适于胎龄儿(AGA)42例为正常对照组。采用酶联免疫反应法(ELISA)对新生儿脐血Ghrelin、胰岛素、IGF-1进行测定分析,测量新生儿净体重、身长、头围、胎盘体积、胎盘重量,计算体重指数(BMI)和胰岛素敏感指数(ISI)。结果(1)SGA组脐血Ghrelin水平(38.74±4.90ng/mL)明显高于正常对照组(23.37±8.78ng/mL),其差异有统计学意义(P<0.05)。(2)脐血Ghrelin水平与新生儿出生体重、身长、头围、BMI、胎盘重量、胎盘体积呈负相关,均有统计学意义(P<0.05)。(3)脐血Ghrelin水平与IGF-1、胰岛素、ISI呈负相关均有统计学意义(P<0.05)。与血糖无相关性(r=0.081,P=0.454)。(4)通过偏相关分析,控制出生体重、身长、胎盘重量、BMI、胰岛素后,Ghrelin与IGF-1有明显负相关性,有统计学意义。(5)剖宫产新生儿脐血Ghrelin水平与顺产儿无明显差异(P=0.956);男性与女性新生儿脐血Ghrelin水平无明显差异(P=0.385)。结论新生儿脐血Ghrelin水平是反映胎儿的宫内发育及营养状态的指标之一。并以负反馈形式参与胎儿宫内发育和代谢轴的调控过程。小于胎龄儿出生时可能存在胰岛素抵抗。小于胎龄儿高Ghrelin并没有刺激胰岛素释放,提示小于胎龄儿可能存在Ghrelin受体或受体后信号传导通路的抵抗。
Objective To compare the changes of cord blood Ghrelin levels in cordless blood with gestational age (SGA) and full-term normal neonates. The relationship between cord blood Ghrelin and newborn birth weight, body length, head circumference, BMI and placenta weight, placenta volume, Relationship between serum Ghrelin levels and IGF-1, insulin, insulin sensitivity and blood glucose. To investigate the relationship between umbilical cord blood Ghrelin levels and fetal development and the metabolic axis, especially Ghrelin and IGF-1. Methods From December 2006 to March 2007, 78 neonates were selected from the First Affiliated Hospital of Sun Yat-sen University. Twenty-two SGA patients were observed. Forty-two full-term AGA patients were used as control group. Neonatal umbilical blood Ghrelin, insulin and IGF-1 were measured by enzyme-linked immunosorbent assay (ELISA). Net weight, body length, head circumference, placenta volume, placental weight, body mass index (BMI) Sensitive Index (ISI). Results (1) The level of Ghrelin in cord blood of SGA group (38.74 ± 4.90ng / mL) was significantly higher than that of normal control group (23.37 ± 8.78ng / mL), the difference was statistically significant (P <0.05). (2) The level of Ghrelin in cord blood was negatively correlated with birth weight, body length, head circumference, BMI, placental weight and placenta volume (all P <0.05). (3) The levels of Ghrelin in cord blood were negatively correlated with IGF-1, insulin and ISI (P <0.05). No correlation with blood glucose (r = 0.081, P = 0.454). (4) By partial correlation analysis, control of birth weight, length, placental weight, BMI, insulin, Ghrelin and IGF-1 was significantly negatively correlated, with statistical significance. (5) There was no significant difference in cord blood Ghrelin level between newborns with cesarean section and that of the newborns (P = 0.956). There was no significant difference in Ghrelin level between the male and female neonates (P = 0.385). Conclusion Neonatal cord blood Ghrelin level is one of the indicators of intrauterine development and nutritional status of the fetus. And negative feedback form involved in fetal intrauterine development and metabolic regulation of the axis. Insufficient insulin resistance may occur at birth less than gestational age. Ghrelin in children younger than gestational age did not stimulate insulin release, suggesting that there may be resistance to Ghrelin receptors or post-receptor signaling pathways in children younger than gestational age.