瘦素与胎儿生长发育关系的探讨

目的探讨瘦素与胎儿生长发育的关系。方法采用放射免疫法检测90例足月剖宫产孕妇母血及脐血中瘦素水平,根据新生儿出生体重分为小于胎龄儿(SGA17例)、适于胎龄儿(AGA47例)和大于胎龄儿(LGA26例)3组;巢式反转录-聚合酶链反应技术测定21例胎盘组织中瘦素mRNA的相对表达量(SGA组、AGA组、LGA组各7例)。采用新生儿出生体重和Ponderal指数估测胎儿生长发育状态。结果①母血瘦素水平与胎儿出生体重、Ponderal指数和胎盘重量无相关关系,与母体体重指数(BMI)呈显著正相关。②脐血瘦素水平与胎儿出生体重、Ponderal指数、胎盘瘦素mRNA表达量和胎盘重量呈显著正相关,3组间比较,差异有统计学意义(P<0.01),其中SGA组显著低于AGA组、LGA组显著高于AGA组。③胎盘组织中瘦素mRNA的相对表达量与胎儿出生体重、Ponderal指数和胎盘重量呈显著正相关(P<0.01),3组间比较,差异有统计学意义(P<0.01),其中SGA组显著低于AGA组、LGA组显著高于AGA组。结论母血瘦素水平不能预测胎儿体重,脐血瘦素水平和胎盘瘦素mRNA与胎儿生长发育密切相关。

Investigate the relationships between leptin and fetal growth

Objective To investigate the relationship between leptin and fetal growth and development.Methods The levels of maternal blood leptin and cord blood leptin in 90 healthy full-term deliveries were examined by radio immunoassay(RIA).All subjects were categorized as SGA(17 cases),AGA(47 cases) and LGA(26 cases) according to birth weight.The relative expression of leptin-mRNA in 21 placenta,include SGA(7 cases),AGA(7 cases) and LGA(7 cases),determined by semi-quantitative nested RT-PCR.Results ①Maternal leptin was markedly positively correlated with maternal BMI,but not with birth weight,Ponderal index and placental weight.②Cord leptin was markedly positively correlated with birth weight,Ponderal index and placental weight,the expression of leptin-mRNA in placenta and placental weight.Among three groups,there was significant difference(P<0.01),.Cord leptin in LGA group and in SGA group was,respectively higher and lower than that in AGA group.③The expression of leptin-mRNA in AGA placenta was,respectively,lower and higher than that in LGA placenta and in SGA placenta.The relative expression of leptin-mRNA was associated to birth weight,Ponderal index and placental weight.Conclusion To monitor maternal leptin can not predict fetal birth weight during pregnancy.Cord leptin and the expression of leptin-mRNA are closely correlated with fetal growth and development.