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目的旨在揭示脐血脂联素、瘦素及胰岛素样生长因子-I(IGF-Ⅰ)与胎儿生长发育的关系,探讨其在胎儿生长发育方面的相互作用及临床意义。方法采用放射免疫法测定86例新生儿脐血脂联素、瘦素、IGF-Ⅰ水平,根据胎龄及出生体质量百分位数的关系分为:SGA组16例,AGA组41例及LGA组29例,同时测量新生儿的出生体质量、身长、头围、足长、胎盘重量并计算体重指数(BMI)。结果脐血瘦素、脂联素及IGF-Ⅰ水平均LGA组>AGA组>SGA组。脐血脂联素水平与出生体质量、胎盘重量、BMI水平均呈正相关(P均<0.05)。脐血瘦素及IGF-Ⅰ水平分别与新生儿出生体质量、身长、头围、足长、BMI及胎盘重量呈显著正相关(P<0.01),脐血瘦素与脂联素、IGF-Ⅰ水平亦呈显著正相关(P<0.01)。脐血瘦素、脂联素水平与新生儿性别及分娩方式间均差异无统计学意义(P>0.05);脐血IGF-Ⅰ水平与新生儿性别差异无统计学意义(P>0.05),与新生儿分娩方式差异有统计学意义(P<0.05)。结论脐血瘦素、脂联素、IGF-Ⅰ在调节胎儿生长发育方面起着重要作用,参与胎儿的生长发育过程,可作为评价胎儿生长发育及营养状态的临床指标之一。脐血瘦素、IGF-Ⅰ水平异常可能是引起胎儿宫内生长迟缓和巨大儿发生的原因之一。
Objective To reveal the relationship between cord blood adiponectin, leptin and insulin-like growth factor-I (IGF-I) and fetal growth and development, to explore its interaction in fetal growth and clinical significance. Methods Cord blood adiponectin, leptin and IGF-Ⅰ levels were measured by radioimmunoassay in 86 newborns. According to the relationship between gestational age and birth weight percentile, 16 cases in SGA group, 41 cases in AGA group and LGA In the group of 29 cases, birth weight, length, head circumference, foot length, placental weight and body mass index (BMI) were measured simultaneously. Results Cord blood leptin, adiponectin and IGF-Ⅰ levels were LGA group> AGA group> SGA group. Cord blood adiponectin levels and birth weight, placental weight, BMI levels were positively correlated (P all <0.05). Cord blood leptin and IGF-Ⅰ levels were positively correlated with birth weight, body length, head circumference, foot length, BMI and placental weight respectively (P <0.01). Cord blood leptin, adiponectin and IGF- Ⅰ level also showed a significant positive correlation (P <0.01). There was no significant difference in cord blood leptin, adiponectin levels and neonatal gender and mode of delivery (P> 0.05). The level of IGF-Ⅰ in umbilical cord blood was not significantly different from that in neonates (P> 0.05) There was a significant difference in neonatal delivery mode (P <0.05). Conclusion Cord blood leptin, adiponectin and IGF-Ⅰ play an important role in the regulation of fetal growth and development, and participate in the growth and development of the fetus, which can be used as one of the clinical indicators to evaluate the fetal growth and nutritional status. Abnormal cord blood leptin, IGF-Ⅰ levels may be one of the causes of delayed intrauterine growth and macrosomia.