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目的探讨胃饥饿素(Ghrelin)、胰岛素样生长因子-1(IGF-1)及瘦素(Leptin)在足月小于胎龄儿(SGA)中的作用及其关系。方法本院产科出生的足月SGA和适于胎龄儿(AGA)各30例,生后测量体重、身长、头围,并计算体重指数(BMI),生后第3天测定血Ghrelin、IGF-1及Lep-tin水平。结果 SGA组体重、身长、头围、BMI均明显低于AGA组[(2280±190)g比(3220±320)g,(46.3±1.8)cm比(50.5±2.0)cm,(31.8±1.1)cm比(33.6±1.1)cm,(10.6±0.8)cm比(12.6±0.9)cm,P均<0.05]。SGA组血清IGF-1及Leptin水平均低于AGA组[(49.6±10.3)μg/L比(55.3±9.9)μg/L,(2.4±0.8)μg/L比(3.0±1.0)μg/L],血浆Ghrelin水平高于AGA组[(25.2±11.0)μg/L比(17.3±7.4)μg/L],P均<0.05。两组IGF-1与体重呈正相关,Leptin与体重、身长呈正相关,Ghrelin与体重、BMI呈负相关,P均<0.05。两组Ghrelin水平与IGF-1呈负相关,IGF-1与Leptin呈正相关;SGA组Ghrelin水平与Leptin呈负相关,P均<0.05。结论生后早期SGA新生儿存在高Ghrelin、低IGF-1、低Leptin水平状态。Ghrelin、IGF-1及Leptin共同参与胎儿宫内营养的调节,相互起协同及拮抗作用。
Objective To investigate the role of ghrelin, insulin-like growth factor-1 (IGF-1) and leptin in term infants with gestational age (SGA). Methods 30 pregnant women with full-term SGA and gestational age (AGA) were enrolled in this study. Body weight, length, head circumference and body mass index (BMI) were measured after birth. Blood Ghrelin, IGF -1 and Lep-tin levels. Results The body weight, length, head circumference and BMI in SGA group were significantly lower than those in AGA group [(2280 ± 190) g vs (3220 ± 320) g vs (46.3 ± 1.8) cm vs (50.5 ± 2.0) cm vs ) cm (33.6 ± 1.1) cm, (10.6 ± 0.8) cm (12.6 ± 0.9) cm respectively, P <0.05]. The levels of serum IGF-1 and Leptin in SGA group were significantly lower than those in AGA group (49.6 ± 10.3 μg / L vs 55.3 ± 9.9 μg / L, (2.4 ± 0.8) μg / L vs 3.0 ± 1.0 μg / L ], And plasma Ghrelin level was higher than that of AGA group [(25.2 ± 11.0) μg / L vs (17.3 ± 7.4) μg / L], P <0.05. There was a positive correlation between IGF-1 and body weight in both groups. Leptin was positively correlated with body weight and body length. There was a negative correlation between Ghrelin and body weight and BMI (P <0.05). There was a negative correlation between Ghrelin level and IGF-1, IGF-1 and Leptin in SGA group, and Leptin level in SGA group (P <0.05). Conclusion There are high Ghrelin, low IGF-1 and low Leptin levels in newborns of SGA after birth. Ghrelin, IGF-1, and Leptin are involved in the regulation of fetal intrauterine growth and are synergistic and antagonistic to each other.