GDM大鼠胎盘脂联素基因表达水平与胎鼠出生体重的关系

目的:探讨妊娠期糖尿病大鼠胎盘脂联素与胎鼠出生体重的关系。方法:育龄雌性SD大鼠受孕后随机分为正常妊娠组、妊娠期糖尿病组、共轭亚油酸治疗组。腹腔内注射45mg/kg链尿佐菌素,建立妊娠期糖尿病大鼠模型。注射药物3天后用共轭亚油酸3.0g/(kg·d)灌胃至孕19天,建立共轭亚油酸治疗组大鼠模型。孕19天后解剖大鼠,计数胚胎存活数并测量胎鼠体重。采用葡萄糖氧化酶法测定血糖;采用放射免疫法测定血清胰岛素;采用ELISA试剂盒检测大鼠血清脂联素和胎盘组织脂联素浓度;采用RT-PCR技术检测脂肪组织脂联素和过氧化物增殖物激活受体γmRNA的表达和胎盘组织脂联素mRNA的表达,并进行半定量分析。结果:①共轭亚油酸可降低妊娠期糖尿病大鼠血糖和胰岛素水平,增加脂肪组织中过氧化物增殖物激活受体-γmRNA、脂联素mRNA的表达和胎盘组织中脂联素mRNA的表达水平,相应地,妊娠期糖尿病大鼠血清中和胎盘组织中脂联素的浓度也升高。②3组大鼠的胚胎存活数无统计学差异。③胎盘脂联素mRNA表达水平与胎鼠出生体重呈显著负相关关系。结论:①共轭亚油酸可降低妊娠期糖尿病大鼠血糖水平,并改善血糖升高后刺激胰岛素大量分泌的状态,改善胰岛素抵抗。②共轭亚油酸可通过激活过氧化物增殖物激活受体γ来提高妊娠期糖尿病大鼠脂联素水平。③胎盘组织有脂联素基因的表达,妊娠期糖尿病病理状态可影响脂联素基因在胎盘的表达水平,共轭亚油酸可上调脂联素mRNA的表达水平,并且胎盘组织中脂联素浓度升高。④妊娠期糖尿病病理状态对胚胎存活数影响不大,但胎鼠出生体重增加。⑤胎盘来源的脂联素可能参与了胎儿生长发育的调节。     

脂联素与胎儿生长发育的关系及其研究进展

脂联素(adiponectin)是由脂肪细胞分泌的一种特异性蛋白。近年研究发现,脂联素与胎儿生长发育有着密切的关系。脂联素可调控胎儿体重的增长,在胎儿生长发育中起着重要的作用,成为近年的研究热点之一。胎儿脂联素可受到激素、性别、遗传等因素影响,本文将对脂联素与胎儿生长发育     

血清脂联素在极低出生体重早产儿静脉营养性胆汁淤积风险评估中的作用

目的探讨血清脂联素(APN)在极低出生体重早产儿静脉营养性胆汁淤积(PNAC)风险评估中的作用。方法选取2015年1月-2016年12月该院NICU收治的112例极低体重早产儿为研究对象,将血清APN≥13.15 mg/L的51例患儿设为高APN组,血清APN13.15 mg/L的61例患儿为低APN组。记录5周内患儿PNAC情况,分析PNAC发病率及其与APN水平的相关性。结果低APN组PNAC的发生率在第2~5周呈现上升趋势,但血清APN水平则呈现逐步下降趋势。高APN组PNAC的发生率在第2~5周也呈现上升趋势,但血清APN水平变化不明显。两组PNAC发生率差异有统计学意义(P0.01)。单因素分析显示,APN水平是影响患者远期预后的独立危险因素(P0.05)。结论早产儿血清APN参与PNAC的发生发展过程,血清APN可作为极低体重早产儿静脉营养性PNAC的评估预测指标,具有前瞻性,创伤小且检测便捷,对于极低体重早产儿静脉营养及危重抢救有重要价值。     

妊娠早期脂联素水平与妊娠期糖尿病发病的相关性分析

目的观察妊娠早期脂联素(ADP)水平与妊娠期糖尿病(GDM)发病率的相关性。方法选取2014年1月-2015年1月在该院就诊的妊娠早期妇女220例,其中199例纳入研究,于妊娠早期测定空腹血糖水平以排除GDM,于妊娠24~28周行口服葡萄糖耐量试验(OGTT),确诊GDM者41例(GDM组),试验结果阴性者158例(对照组);于妊娠早期和妊娠24~28周检测患者ADP水平,观察ADP与GDM的相关性及ADP对GDM的预测价值。结果两次检查GDM组ADP水平均明显低于对照组(P0.01)。GDM组确诊GDM时ADP水平较妊娠早期有所降低(P0.01)。妊娠早期ADP水平和GDM的发生率呈明显负相关(r=-0.518,P0.01)。妊娠早期ADP水平对GDM有预测价值,敏感度为92.68%,特异性为79.05%,最佳约登指数为0.72,Cut-off值为10.18 ng/L,AUC为0.926。结论妊娠早期ADP水平与GDM的发病呈明显负相关,妊娠早期ADP水平可作为GDM的早期预测指标,具有较高临床价值。     

中枢性性早熟女童体重指数与性激素及瘦素、脂联素水平的相关性研究

目的 研究体重指数对中枢性性早熟女童血清性激素、瘦素(leptin)、脂联素(APN)水平的影响,为临床精确分析GnRHa激发试验结果并阐述瘦素、APN在肥胖儿童青春发育中可能的作用机制。方法 选取苏州大学附属张家港医院2016-2018年完成促性腺激素释放激素类似物(GnRHa)激发试验的特发性中枢性性早熟女童90例,根据体重指数(BMI)分为正常体重组(n=40)、超重组(n=30)、肥胖组(n=20),检测血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E₂)、睾酮(T)、瘦素、APN水平,并运用Spearman相关分析分析BMI与各激素水平的相关性。结果 超重组和肥胖组LH峰值和APN均显著低于正常组(P<0.05),且肥胖组LH峰值和APN也显著低于超重组(P<0.05)。超重组和肥胖组瘦素均显著高于正常组(P<0.05),且肥胖组瘦素也显著高于超重组(P<0.05)。BMI与E₂、T、瘦素水平呈正相关(r=0.213,0.250,0.484,P<0.05),与LH峰值、APN水平呈负相关(r=-0.417,-0.525,P<0.05)。结论 在分析中枢性性早熟女童GnRHa激发试验结果及相关激素水平时需充分考虑BMI对结果的影响。     

2型糖尿病患者的体重指数和血糖、血脂水平与脂联素水平的相关性

近年来研究表明,脂肪组织合成和分泌脂肪因子的调节紊乱是2型糖尿病(DM2)的危险因素。脂肪组织是合成肥胖基因的场所,能分泌多种脂肪因子,如脂联素(APN)等。     

足月新生儿出生体重与母婴脂联素水平的相关性研究

目的探讨足月孕妇和新生儿脐静脉血中脂联素（Adiponectin）水平特点及其与新生儿体重的关系。方法采用放射免疫法测定36例健康育龄期妇女（对照组）和31例正常足月孕妇（妊娠组）及其新生儿脐静脉血（新生儿组）的血清胰岛素及脂联素水平,并进行统计学分析。结果足月孕妇血清脂联素水平最低（11．10±5．72）g／ml;新生儿脐血脂联素水平为（30．71±12．77）g/ml,妊娠组高于对照组妇女（16．52±6．87）g/ml;妊娠组脂联素水平与FINS、HOMA—IR呈负相关（r=-0．411、-0．393,P〈0．05）;新生儿脐血脂联素水平与新生儿出生体重正相关（r=0．416,P〈0．05）;母亲血清脂联素水平与新生儿脐血脂联素及出生体重无相关性。结论（1）新生儿组脂联素水平显著高于对照组及妊娠组;（2）新生儿脐血脂联素水平与其出生体重正相关,表明新生儿脂联素可能与胎儿宫内发育有关;（3）足月孕妇脂联素水平与新生儿脂联素水平、出生体重无相关性。     

足月新生儿出生体重与母婴脂联素水平的相关性研究

Objective To study the characteristics of plasma adiponectin levels exhibiting in gestation women and newborns, as well as the relationships between adiponectin levels and fetal birth weight. Methods Totally 98 subjects have been considered in this study, in-cluding venous blood samples of 36 healthy non-pregnant women (control group), 31 uncomplicated pregnant women (pregnancies group) and the cord blood samples taken at delivery of their singleton infants born at term (newborns group). The concentrations of adiponectin and insulin were determined by radioimmunoassay technique. And SPSS was used for statistical analyses. Results The adiponectin level in women of late period of gestation (WLPG) (11.10±5.72)g/ml was lower than that of other two groups, and the newborns average cord plasma level of adiponectin was (30.71±12.77) g/ml significantly higher than that of the control group (16.52±6.87) g/ml. The adipone-ctin level for WLPG was correlated with FINS and HOMA-IR (r = -0.411, -0.393, P <0.05). The adiponectin level in cord plasma was positively correlated with birth weight(r = 0.416, P < 0.05). The adiponectin level in WLPG was correlated neither with the adiponec-tin level nor body weights of their newborns. Conclusions The average cord plasma adiponectin level of newboms is significantly higher than that of the control group and WLPG. It is positively correlated with birth weight, which suggests that adiponectin may be involved in reg-ulating fetal growth. The adiponectin level in WLPG is correlated neither with the adiponectin level nor body weights of their newborns.     

超重和肥胖人群血清脂联素水平变化与高血压病的关系

目的研究血清脂联素水平与超重、肥胖及与高血压病的关系。方法对深圳地区21岁~60岁人群共21578人进行体重指数(BM I),腰围(WC),腰臀围比(WHR)及血压(HP)测量,按体重指数(BM I)将其分成三大组:正常非肥胖组(BM I≤24kg/m2)共14817人;超重组(2495 cm的人群为133‰。(χ12=821.26,P<0.005),(χ22=500.16,P<0.005)。血清脂联素浓度在肥胖人群及高血压病肥胖患者均显著低于正常人群[脂联素:单纯性肥胖组(7.16±1.41)mg/L,高血压病肥胖组(7.18±1.45)mg/L vs.正常非肥胖组(9.22±0.61)mg/L,F=3.217,P<0.05]。血清脂联素浓度在超重人群与正常人群之间无显著性差异[脂联素:超重组(7.71±1.73)mg/L vs.正常非肥胖组(9.22±0.61)mg/L,P=0.097>0.05]。在高血压病肥胖患者中,脂联素浓度与体重指数、腰围、腰臀围比、、收缩压之间呈显著负相关。结论脂联素水平下降与肥胖、血压之间存在一定的相关性;保持BM I和WC在正常范围,是预防高血压病发生的有效措施之一。     

血清脂联素水平与新疆维吾尔族高尿酸血症的相关性

[目的]研究新疆地区维吾尔族人群血清脂联素水平与高尿酸血症的相关性。[方法]用ELASA酶联免疫法测定413例研究对象的血清脂联素,血清检测血尿酸(SUA)及血脂等相关生化指标。[结果]维吾尔族高尿酸组与对照组的腰围、臀围、腰高比(WHTR)、甘油三酯(TG)及脂联素的差异均有统计学意义,其中高尿酸组血清脂联素水平显著低于对照组(P﹤0.01)。在扣除了体脂因素后脂联素在两组间的差异仍然存在(P﹤0.01),且在正常对照人群中,女性脂联素水平显著高于男性(P﹤0.01)。脂联素与SUA之间存在负相关,与年龄无相关性。[结论]脂联素作为脂肪细胞分泌的特异性蛋白,其与SUA的相关性提示脂联素可能是高尿酸血症发生的特征性指标之一,为维吾尔族高尿酸血症的防治提供依据。     

新生儿脐血IgE阳性与父母过敏史及出生情况的关系

[目的]探讨新生儿脐血IgE阳性与父母过敏史及出生情况的关系。[方法]对临产孕妇进行问卷调查及血清25-羟维生素D₃检测,并采集脐血检测IgE,跟踪新生儿记录出生情况,分析脐血IgE值的相关因素。[结果]母亲有过敏性疾病史、新生儿出生时体重过大、男性及出生时窒息史等与脐血IgE阳性有相关性(OR=1.65、3.36、1.90和2.88,P<0.05)。[结论]母亲有过敏史是脐血IgE升高的危险因素,应做好母亲有过敏史婴儿的湿疹防治工作。     

脐血叶酸水平与新生儿出生体重和肺透明膜病的关系

目的 探讨脐血叶酸水平与新生儿出生体重和肺透明膜病的关系.方法 将87例新生儿按照胎龄、出生体重、临床表现及胸部X线检查分别分为早产儿组(42例)和足月儿组(45例)、胎儿宫内发育迟缓组(28例)和正常妊娠对照组(59例)、早产儿肺透明膜病组(13例)和早产儿对照组(15例),测定各组新生儿脐血叶酸水平.结果 早产儿组脐血叶酸水平低于足月儿组[(10.87±4.31)nmol/L比(13.56±5.07)nmol/L,P＜0.05];胎儿宫内发育迟缓组脐血叶酸水平低于正常妊娠对照组[(11.01±4.29)nmol/L比(14.87±5.14)nmol/L,P＜0.05];早产儿肺透明膜病组脐血叶酸水平低于早产儿对照组[(9.15±4.02)nmol/L比(12.91±4.51)nmol/L,P＜0.05];脐血叶酸水平与新生儿出生体重呈正相关(r=0.1825).结论 脐血叶酸水平与早产、胎儿宫内发育迟缓和新生儿肺透明膜病的发生有关.

Abstract：

Objective To explore the relationship between folic acid levels of cord blood and birth weight, hyaline membrane disease in newborns. Methods Eighty-seven newborns were divided into premature infant group(42 cases) and term infant group(45 cases),intrauterine growth retardation group( 28cases) and control group (59 cases), hyaline membrane disease of premature infant group ( 13 cases) and premature infant control group(15 cases) according to the gestational age, birth weight, clinical manifestation and chest X-ray, respectively. Folic acid levels of cord blood were measured. Results The folic acid level of cord blood in premature infant group was lower than that in term infant group [(10.87 ±4.31) nmol/L vs.( 13.56 ± 5.07) nmol/L,P ＜0.05 ]. The folic acid level of cord blood in intrauterine growth retardation group was lower than that in control group [(11.01±4.29)nmol/L vs.( 14.87 ± 5.14)nmol/L,P＜0.05]. The folic acid level of cord blood in hyaline membrane disease of premature infant group was lower than that in premature infant control group [(9.15 ±4.02) nmol/L vs.(12.91±4.51) nmol/L,P＜0.05]. The positively correlation was found between the folic acid level of cord blood and birth weight in newborns (r =0.1825).Conclusion The folic acid level of cord blood is correlated with the occurrence of premature infants,intrauterine growth retardation and hyaline membrane disease in newborns.     

脐血脂联素与妊娠期糖尿病巨大儿发生关系的研究

目的:探讨脐血脂联素水平与妊娠期糖尿病巨大儿发生的关系。方法:选择孕期诊为GDM并且血糖控制满意的孕妇236例作为研究组,同期正常妊娠的孕妇251例作为对照组,追踪所有孕妇分娩的新生儿体重,新生儿出生体重≥4.0 kg为巨大儿。所有新生儿出生后即抽取脐血测脂联素水平,并记录出生体重、身长、肩围及腹壁皮下脂肪厚度,计算胰岛素抵抗指数HOMA-IR和新生儿营养指数RI。结果:GDM组巨大儿出生体重、RI及HOMA-IR均高于正常对照组巨大儿,差异有统计学意义(P<0.05),GDM组脐血脂联素水平明显低于对照组(P<0.05)。GDM组巨大儿脐血脂联素与出生体重、RI成负相关关系(P<0.05),与HOMA-IR成正相关关系(P<0.05),而与巨大儿身长、头围、肩围及腹壁皮下脂肪厚度不相关(P>0.05)。结论:脐血脂联素与胎儿宫内生长发育关系密切,脐血APN水平可直接反映巨大儿的体脂含量。     

Maternal and cord blood manganese (Mn) levels and birth weight: The MIREC birth cohort study

Epidemiological studies have hypothesized that both insufficient and excess blood manganese (Mn) levels during pregnancy are associated with reduced fetal growth. This literature is characterized by inconsistent results and a limited focus on women with exposures representative of the general North American population. We examined the relationship between maternal and cord blood Mn levels and fetal growth among women enrolled in the Maternal-Infant Research on Environmental Chemicals Study (MIREC). Mothers with singleton, term infants and complete maternal first and third trimester blood Mn data were eligible for inclusion in the present study (n?=?1519). Mean birth weight and odds ratios of small for gestational age (SGA) births according to maternal and cord blood Mn levels (low (<10), referent (10–<90), high (≥90) percentiles) were estimated. We also evaluated the association between the ratio of cord and maternal blood Mn and birth weight. Women with low (<0.82?μg/dL) maternal blood third trimester Mn levels had infants that weighed an average of 64.7?g (95% CI: ?142.3,12.8) less than infants born to women in the referent exposure group. This association was strengthened and became statistically significant when adjusted for toxic metals (lead, mercury, arsenic, and cadmium) [?83.3?g (95% CI: ?162.4, ?4.1)]. No statistically significant associations were observed in models of maternal first trimester or cord blood Mn. A one unit increase in the cord/maternal blood Mn ratio was associated with a 29.4?g (95% CI: ?50.2, ?8.7), when adjusted for maternal and neonatal characteristics. Our findings motivate additional research regarding the relation between Mn exposure and fetal growth. Further inquiry is necessary to determine whether an exposure threshold exists, how growth related effects of maternal and fetal Mn may differ, and how concurrent exposure to other toxic metals may impact the association between Mn and growth.     

1180例新生儿脐血红细胞参数分析

目的:探讨影响新生儿脐血红细胞参数的因素。方法:采集1 180例新生儿脐血,利用全自动红细胞分析仪检测红细胞数(RBC)、血红蛋白含量(HB)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞压积(HCT)、红细胞体积分布宽度(RDW)。分析不同性别、孕周及分娩方式新生儿脐血红细胞参数的差异。结果:男性新生儿的RBC、HB、HCT和RDW高于女性新生儿(P<0.05),MCV和MCH低于女性新生儿(P<0.05);足月产儿的HB、MCV、MCH和RDW低于早产儿(P<0.05);顺产新生儿的RBC、HB和HCT较剖宫产儿高(P<0.05)。结论:新生儿脐血红细胞参数受性别、孕周及分娩方式等因素的影响;了解新生儿红细胞参数,有助于某些遗传性血液病的早期筛查。     

脐血铅、初乳铅含量对新生儿神经行为发育的影响

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系.方法 随机选取南京市妇幼保健院医院产科2010年1-4月出生的足月新生儿170例.以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为NBNA发育评分作为效应指标.结果 高暴露组和低暴露组在新生儿主动肌张力、原始反射和神经行...     

新生儿脐血IgE值与母孕期及婴儿出生情况相关性研究

目的：探讨影响新生儿脐血IgE值的可疑因素并为降低脐血IgE值提出早期干预措施。方法：对将分娩孕妇进行问卷调查及血25-羟维生素D3检查,并于分娩时采集脐血IgE,跟踪新生儿,记录出生情况,对影响脐血IgE的因素进行统计分析。结果：母亲有过敏性疾病史、新生儿出生时体重过大、性别为男孩及出生时有窒息史与脐血IgE值阳性存在相关性。结论：父母亲尤其是母亲的过敏史是导致脐血IgE升高的危险因素,同时,新生儿的出生情况包括体重、性别、窒息史等与IgE值有相关性,从而影响了婴儿过敏性疾病的发生。     

产妇和新生儿体内重金属水平及其影响因素分析

目的了解某地区产妇及新生儿血砷、汞和铅的水平,分析其相关影响因素。方法在某地区随机抽取A、B两所医院,选择2012年4—5月间住院分娩的产妇共226名,采集产妇静脉血和新生儿脐带血,采用电感耦合等离子体质谱法测定全血中砷、汞和铅的浓度,并对产妇进行问卷调查。结果 226对产妇和新生儿血铅浓度范围分别为2.65~67.00μg/L和4.05~70.89μg/L,均低于100μg/L的限值;A医院产妇和新生儿血砷平均浓度分别为1.20μg/L和1.23μg/L,均高于B医院(0.62μg/L和0.71μg/L),差异具有统计学意义(P0.05),血汞和血铅浓度差异均无统计学意义(P0.05);新生儿脐带血中砷、汞和铅浓度与产妇静脉血中同种元素浓度呈显著正相关(P0.01),相关系数分别为0.925、0.832和0.765;多重线性回归分析结果显示,家庭年收入越高,产妇及其新生儿血砷浓度越高(P0.05);产妇文化程度则对血铅水平有显著影响,文化程度越高,产妇及其新生儿血铅浓度越低(P0.05)。结论该地区产妇和新生儿体内砷、汞、铅暴露水平较低,但胎盘对重金属缺乏有效屏障作用,仍应采取有效措施减少产妇和新生儿重金属暴露。     

Correlation between maternal and cord blood lead levels

Whole blood lead levels were estimated by atomic absorption analysis in 226 blood samples from 113 mothers of 23 different nationalities. Samples were collected before delivery, and from cord blood from their respective neonates. The concentrations of blood lead were within the expected range of occupationally unexposed populations. Mean maternal blood lead levels were 0.72 0.10 mumol/l (14.9 2.14 mug/dl), range 0.32-1.34 mumol/l (6.6-27.8 mug/dl) and mean cord blood levels were 0.64 0.12 mumol/l (range 0.29-1.46 mumol/l). Sixteen percent of the mothers and nearly 10% cord blood samples were found to have blood lead level greater than 0.97 mumol/l (20 mug/dl). Very high levels, in excess of 1.21 mumol/l (25 mug/dl), were detected in 3.5% of mothers as compared to 2.6% of cord blood samples. Out of 113 infants, 65 (58%) were males with a mean cord blood lead level of 0.63 mumol/l and 48 (42%) were females with a mean level of 0.66 muol/l. The lowest maternal blood lead levels 0.68 mumol/l were observed in ages 20 to 25 years old, and lowest cord blood levels 0.58 mumol/l were seen in maternal age of less than 20 years old. On the other hand, the highest maternal and cord blood lead levels (0.82 and 0.75 mumol/l, respectively) were observed in maternal ages of greater than 35 years old. The results show a direct correlation of blood lead level between mothers and umbilical cord as seen in the linear regression distribution curve.     

广州地区500例母乳铅与母血、脐血铅含量的相关性分析

目的:了解广州地区产妇母乳铅含量与母血、脐血铅含量之间的相关性。方法:采用电感耦合等离子体质谱仪(ICP-MS)对广州地区500例产妇抽取母血、脐血、母乳中铅含量进行测定,并进行三者之间的相关性分析。结果:母血铅含量为0~67.590μg/L,均值为(22.005±12.861)μg/L,脐血铅含量为0~69.370μg/L,均值(26.760±9.223)μg/L,母乳铅含量为0~80.420μg/L,均值为(4.474±8.760)μg/L,母血铅与脐血铅含量呈显著正相关(r=0.341,P=0.001),母乳中铅含量与母血中铅含量的相关性没有统计学意义(r=0.064,P=0.367),母乳中铅含量与脐血中铅含量的相关性没有统计学意义(r=0.001,P=0.995)。结论:母血铅含量与脐血铅含量成正相关,血铅可通过胎盘转运给胎儿,母乳中铅含量较母血中铅含量低,母乳喂养是安全的。