脐血血清促代谢因子水平与胎儿生长发育的关系

目的 探讨脐血血清促代谢因子(betatrophin)水平与胎儿生长发育的关系,为胎儿保健提供依据。方法 2018年1-7月选择瑞安市人民医院妇幼分院出生的大于胎龄儿(LGA)、适于胎龄儿(AGA)和小于胎龄儿(SGA)各30例。检测脐血、母血和羊水betatrophin水平,分析脐血血清betatrophin水平与胎儿生长发育各指标、糖脂代谢指标、瘦素和脂联素等的相关性。结果 LGA、AGA、SGA的脐血血清betatrophin水平分别为(1 009.210±98.761)、(929.487±80.949)、(910.590±105.518)ng/L,差异有统计学意义(F=8.986,P＜0.001);三组新生儿血脂各指标水平比较差异均无统计学意义(P>0.05);相关分析显示脐血betatrophin水平与新生儿出生体重、重量指数(PI)、胎龄,脐血瘦素、甘油三酯水平呈正相关(r=0.537、0.502、0.250、0.422、0.832,P＜0.05),与脐血脂联素水平呈负相关(r=-0.257、P＜0.05),与母血和羊水betatrophin水平,孕前和分娩时体重量、孕前体重指数(BMI)、孕期体重指数增加量(ΔBMI),胎盘重量,脐血和产妇血糖(PG)、胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)无相关性(P>0.05);多元线性回归分析显示血betatrophin是新生儿出生体重独立影响因素(P＜0.05)。结论 Betatrophin参与胎儿生长发育调节,脐血betatrophin水平可反映胎儿的生长发育状况。

Relationship between serum betatrophin in cord blood and growth development of fetus

Objectives To investigate the relationship between serum betatrophin and growth development among fetus,in order to provide reference for fetal healthcare. Methods Totally 30 large for gestational age(LGA)infants,30 appropriate for gestational age(AGA) infants and 30 small for gestational age(SGA) infants were enrolled in this study in Maternal and Child Health Hospital of Ruian People′s Hospital from January to July 2018. Serum betatrophin level in cord blood,maternal blood and amniotic fluid was tested,and the relationships among betatrophin in cord blood,indexes of fetal growth and development,glucose and lipid metabolic parameters,insulin resistance,leptin and serum adiponectin were analyzed. Results The serum betatrophin levels in cord blood of LGA,AGA and SGA were (1 009.210±98.761) ng/L,(929.487±80.949) ng/L and (910.590±105.518) ng/L respectively,with significant difference among three groups(F=8.986,P<0.001). There were no significant differences on lipid indexes among LGA,AGA and SGA infants(P>0.05). Pearson correlation analysis indicated that serum betatrophin level in cord blood was positively correlated with birth weight,ponderal index(PI) and gestational age of neonates,leptin and triglyceride(TG) in cord blood(r=0.537,0.502,0.250,0.422,0.832,P<0.05),and negative correlation was found between serum betatrophin and adiponectin level in cord blood(r=-0.257,P<0.05).However,there were no significant correlations between serum betatrophin level and betatrophin level in maternal blood or amniotic fluid,body weight before pregnancy and delivery,pre-pregnancy BMI,BMI increase during pregnancy,placental weight,plasma glucose(PG),insulin(INS) and HOMA-IR in cord and maternal blood(P>0.05). Multivariate linear regression analysis showed that blood betatrophin was an independently influencing factor for neonatal birth weight(P＜0.05). Conclusions Betatrophin level of cord blood is related to the adjustment of fetal growth. On the other hand,betatrophin level can reflect the status of feta1 growth and development.