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目的:探讨胰岛素基因的串联重复可变序列(INS-VNTR)与出生大小和婴儿生长发育的相关性。方法:采用队列研究的方法,在孕妇分娩后留取脐带组织或脐血,并随访活产新生儿至12月。使用rs689(-23HphI)的A/T基因分别作为INS-VNTR Ⅰ/Ⅲ基因的标志,应用多元两分类Logistic回归和混合线性模型分别分析INS-VNTR对出生大小及婴儿生长发育的影响。结果:575例胎儿中,Ⅰ/Ⅰ型为524例,占91.13%;Ⅰ/Ⅲ型50例,占8.70%;Ⅲ/Ⅲ型仅1例,占0.17%。含有Ⅲ等位基因的携带者与Ⅰ/Ⅰ基因型相比,出生体重、身长、BMI及巨大儿发生率差异无统计学意义(P>0.05)。在随访到的474名1岁婴儿生长发育资料中,Ⅰ/Ⅰ基因型与Ⅰ/Ⅲ基因型携带者相比,婴儿期的体重、身长、头围、BMI值之Z值差异无统计学意义(P>0.05)。结论:INS-VNTR基因与出生大小及婴儿生长发育之间无相关性(P>0.05),但由于Ⅲ/Ⅲ基因型频率在中国大陆汉人中的低发生率,因而INS-VNTR对中国大陆汉人出生大小及婴儿生长发育的影响还有待将来进一步的研究来充实。
Objective: To investigate the relationship between INS-VNTR and birth size and infant growth and development. Methods: A cohort study was conducted to collect umbilical cord tissue or umbilical cord blood from pregnant women after childbirth and to follow up live births until December. The rs689 (-23HphI) A / T gene was used as the marker of INS-VNTR Ⅰ / Ⅲ gene, and the influence of INS-VNTR on the size and infant growth and development of infants was analyzed by using multivariate binary Logistic regression and mixed linear models respectively. Results: Among 575 fetuses, Ⅰ / Ⅰ type was 524 cases (91.13%), Ⅰ / Ⅲ type was 50 cases (8.70%) and Ⅲ / Ⅲ type was only 1 case (0.17%). Compared with Ⅰ / Ⅰ genotypes, there was no significant difference in birth weight, body length, BMI and macrosomia among carriers with Ⅲ allele. Among 474 1-year-old infants who were followed up, there was no significant difference in Z value between infants’ body weight, length, head circumference and BMI compared with those with Ⅰ / Ⅰ genotype (P> 0.05). Conclusion: There is no correlation between INS-VNTR gene and birth size and infant growth and development (P> 0.05). However, due to the low frequency of Ⅲ / Ⅲ genotype in Han Chinese, INS- The impact of birth size and infant growth and development remains to be further studied in the future.