Intracellular magnesium and adipokines in umbilical cord plasma and infant birth size

Many epidemiologic studies have disclosed that restricted fetal growth has been associated with an increased risk of insulin resistance in adulthood. We studied the relationship of intracellular magnesium [Mg2+]i in cord blood platelets to adipocytokine and birth size. The subjects were 20 infants with small for gestational age (SGA) and 45 infants with appropriate for gestational age (AGA). By using a fluorescent probe, we examined [Mg2+]i of platelets in the cord blood. Cord plasma insulin, IGF-I, ghrelin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), and leptin levels were determined with the use of ELISA. Mean [Mg2+]i was lower in the SGA than in the AGA groups (p < 0.001). Adiponectin and IGF-I were also lower in the SGA than in the AGA, whereas PAI-1 was higher in the SGA. [Mg2+]i was significantly correlated with birth weight, birth length, and adiponectin. Birth weight was also correlated with cord plasma IGF-I, adiponectin, and leptin. Quantitative insulin sensitivity check index (QUICKI) was lower in the SGA group than in the AGA group. [Mg]i and adiponectin were correlated with QUICKI in all subjects. [Mg]i, as well as leptin and IGF-I, reflect the extent of fetal growth. Decreased [Mg2+]i may be involved in the underlying processes to insulin resistance.     

小于胎龄儿青春前期女孩硫化脱氢表雄酮和胰岛素水平的研究

目的探讨小于胎龄儿(SGA)青春前期女孩肾上腺机能初现及是否具有肾上腺机能早现、高肾上腺雄激素血症、高胰岛素血症和胰岛素抵抗现象。方法以符合纳入标准的SGA 39例为研究对象,年龄(7.4±1.7)岁,42例适于胎龄儿(AGA)为对照组,年龄(7.4±1.7)岁。在隔夜空腹12 h后,行身体检查,并抽血检测空腹血糖、胰岛素、硫化脱氢表雄酮(DHEAS)、皮质醇和雌二醇。胰岛素敏感性用空腹血糖与胰岛素乘积的倒数再取自然对数来评价。结果两组中未发现肾上腺机能早现的临床表现,两组间孕母孕龄、年龄、体重指数、空腹血糖、皮质醇、雌二醇和胰岛素敏感性指数差异无统计学意义。SGA组出生体重、研究时的身高和体重均低于AGA组,SGA血清胰岛素和DHEAS水平均高于AGA组(对数转换值:1.076±0.041vs.1.050±0.051,P<0.05;2.637±0.271vs.2.514±0.250,P<0.05)。AGA组DHEAS值在7岁以后出现明显增加,SGA组DHEAS值出现增加的趋势与AGA组比较有所提前。结论AGA女孩肾上腺机能初现的年龄约为7岁,而SGA女孩肾上腺机能初现有始动提前的趋势,青春前期SGA女孩有高肾上腺雄激素血症和胰岛素水平升高的现象,但以胰岛素敏感性指数来评价,尚未发现胰岛素抵抗现象。     

34 周以下适于胎龄及小于胎龄早产儿出生 2 周内 蛋白质、能量摄入及体质量变化

目的了解34周以下早产适于胎龄儿(AGA)和小于胎龄儿(SGA)生后蛋白质、能量摄入量以及体质量z评分的变化情况。方法回顾收集2012年1月至2014年12月入院的314例早产儿,比较268例AGA和46例SGA早产儿生后2周内蛋白质、能量摄入情况和体质量变化。结果 SGA组住院时间、肠外联合肠内营养时间、全肠内营养时间、达足量喂养时间均较AGA早产儿长,差异有统计学意义(P??0.05);SGA组生后第4、8、12天能量摄入量明显低于AGA组,SGA组生后第6、8天总蛋白质摄入量明显低于AGA组,差异均有统计学意义(P??0.05);SGA组日平均体质量增长量大于AGA组,差异有统计学意义(P??0.05);AGA组与SGA组生后2周内体质量z评分均逐渐远离中位水平,且SGA组2周时体质量z评分低于AGA组(P??0.05)。结论胎龄??34周的SGA早产儿恢复出生体质量后的生长速率快于AGA早产儿,存在一定的追赶生长;但SGA、AGA早产儿的生长均有待提高。     

The premature small-for-gestational-age infant during the first year of life: comparison by birth weight and gestational age

To determine the effect of intrauterine growth retardation on the outcome of the premature infant, we compared a group of 35 premature, small-for-gestational-age (SGA) infants with two groups of premature, appropriate-for-gestational-age (AGA) infants: one with similar birth weight (AGA-BW group) and the other with similar gestational age (AGA-GA group). Groups were matched by year of birth, race, gender, and socioeconomic status. Infants were free of major congenital anomalies and intrauterine infection. They were evaluated at term, at 20 and 40 weeks, and at 1 year corrected age. The SGA infants had a lower mean developmental quotient than the two groups of AGA infants. The SGA infants had significantly smaller body dimensions at birth, more nursery complications, and a higher incidence of major neurologic problems than their AGA-GA matches but were comparable to the AGA-BW matches. Poor growth constitutes an additional risk factor to prematurity. The results highlight the importance of comparing premature SGA infants with premature AGA infants of similar gestational age rather than similar birth weight.     

Neurosonographic findings in premature infants and infants with intrauterine growth retardation with a birth weight below 1,500 grams]

The cranial ultrasound of 111 preterm infants were reviewed. 57 patients were appropriate for gestational age (AGA) and 54 small for gestational age (SGA). In the two groups, the incidence of peri-intraventricular hemorrhage (PIVH), posthemorrhagic ventricular dilation (VM) and peri-ventricular leucomalacia (PVL) was compared. PIVH was more common in AGA than in SGA babies (36.8% vs 18.5%). In both groups (AGA and SGA), birth weight less than 1000 g should be considered a further risk factor for hemorrhagic brain lesion (72.2% in AGA babies less than 1000 g and 20.5% ind AGA babies greater than 1000 g birth weight, p less than 0.01) (34.8% in SGA babies less than 1000 g and 6.4% in SGA babies greater than 1000 g birth weight, p less than 0.05). However, ischemic brain lesions (PVL) were not dependent from birth weight (p greater than 0.5). This study shows that low birth weight infants are an eterogeneous group of babies with different risk of hemorrhagic or ischemic cerebral lesion depending on gestational age and birth weight.     

早产和低出生体重及小于胎龄儿与脑性瘫痪发病的关系

目的 明确早产、低出生体重及小于胎龄儿(SGA)与脑性瘫痪(简称脑瘫)的关联程度。方法 1997年5—7月对江苏省7个市的1～6岁儿童进行了现况普查,共查305263名,并对其胎龄、出生体重及胎龄别出生体重与脑瘫的关系进行了分析。结果 本组儿童共发现脑瘫484例,发生率为1．59‰。早产儿及过期产儿脑瘫发生率相对危险性(RR)分别为足月儿的25．16倍及2．40倍;低出生体重及巨大儿的脑瘫发生率RR分别为正常出生体重儿的19．63倍及1．34倍;SGA及大于胎龄儿(LGA)脑瘫发生率RR为适于胎龄儿(AGA)的4．34倍及0．84倍。先按胎龄别出生体重分层再按胎龄分组,发现各层内早产儿脑瘫发生率均较足月儿高,RR最高AGA层为28．34倍,其次LGA层为21．41倍,最低SGA层为9．29倍,各层内过期产儿脑瘫发生率也较足月儿高,RR最高AGA层为2．63倍,其次SGA层为1．90倍,最低LGA层为1．55倍;先按胎龄分层再按胎龄别出生体重分组发现各层内SGA脑瘫发生率均较AGA高,RR最高足月儿层为4．41倍,其次过期产儿层为3．19倍,最低早产儿层为1．45倍,各层内LGA脑瘫发生率均不比AGA高,除足月儿层相近为0．98倍外,早产儿及过期产儿层均较AGA低,RR分别为0．74倍和0．58倍。按胎龄大小及胎龄别出生体重大小联合分成9组进行比较,发现多数组脑瘫发生率均较足月AGA组高,RR按次序为早产SGA40．99倍、早产AGA28．34倍、早产LGA21．08倍、过期SGA8．39倍、足月SGA4．41倍、过期AGA2．63倍、过期LGA1．53倍、足月LGA0．98倍;前6组差异均有显著性,后2组倍数接近1．0,差异无显著性。结论 早产及SGA两种因素均与小儿脑瘫发生率增加关联,这两个因素分别为小儿脑瘫独立的危险因素;过期产与脑瘫的关联很弱,LGA则与脑瘫的发生率增加无关。     

Catch-up growth in infants born small for gestational age--a longitudinal study

BACKGROUND: Epidemiological studies correlate low birth weight and the subsequent development of diabetes mellitus (DM). Early changes in insulin resistance in infants with catch-up growth (CUG) have not been evaluated in our population. AIM: To identify dietary and metabolic features associated with CUG in infants born small for gestational age (SGA) at 1 year old. METHODS: In a cohort study of 88 term infants (44 SGA and 44 appropriate for gestational age [AGA]), breastfeeding and weaning age were registered. Anthropometric measurements, glucose, insulin, and leptin concentrations were measured at birth and at 1 year old. RESULTS: A history of DM in a second-degree relative (p = 0.01) and complementary breastfeeding (p = 0.0003) were higher in SGA compared to AGA infants. Ten (13.6%) infants showed CUG in length and weight combined. They had lower weight, glucose, IR index, and leptin concentrations at birth than those without CUG. After logistic regression analysis for factors related to weight CUG, gender, weaning age, birth weight and leptin concentration at birth were included in the model (R2 = 0.31; p = 0.00004). CONCLUSIONS: Female gender, early weaning, lower birth weight, and lower leptin concentration at birth are related to weight CUG in Mexican infants.     

晚期早产儿中小于胎龄儿的临床特点

目的探讨晚期早产儿中发生小于胎龄儿(SGA)的围产期因素及新生儿期患病特点。方法对2009年10月至2010年9月在我院新生儿重症监护病房住院、胎龄34～36周的晚期早产儿临床资料进行回顾性分析,比较晚期早产儿中SGA和适于胎龄儿(AGA)的围产期因素及新生儿期患病情况。结果 SGA组(179例)住院天数明显长于AGA组(851例)[(16.4±6.2)天比(11.3±4.1)天,P<0.05]。SGA组母亲妊娠期高血压疾病(HDCP)、多胎妊娠、羊水过少和宫内窘迫的比例均高于AGA组(34.1%比17.9%,29.1%比13.7%,21.2%比12.6%,19.6%11.0%,P均<0.01)。SGA组患儿新生儿窒息、喂养不耐受、颅内出血、低血糖和红细胞增多症的发生率亦明显高于AGA组(12.8%比7.9%,7.8%比3.1%,6.1%比2.6%,27.4%比21.4%,3.4%比0.2%,P均<0.05)。结论母亲HDCP和多胎妊娠是造成晚期早产儿SGA的主要原因,SGA患儿相对于AGA患儿具有更高的患病风险,应针对造成SGA的围产期因素以及新生期疾病特点进行相应预防和干预。     

Intrauterine growth restriction and postnatal steroid treatment effects on insulin sensitivity in preterm neonates

OBJECTIVES: To study whether intrauterine growth restriction (IUGR) is associated with decreased sensitivity to the main fetal growth factor, insulin, and the effect of glucocorticoid therapy on insulin sensitivity in preterm infants. STUDY DESIGN: Newborn infants with a birth weight (BW) of< 1500 g were classified as appropriate for gestational age ([AGA], BW within +/- 1 SD, n = 10), or small for gestational age ([SGA], BW <-2 SD, n = 13); 5 AGA infants and 8 SGA infants received systemic steroids. An abbreviated modified minimal model test was performed, consisting of sequential blood samples for glucose and insulin assays, and intravenous infusions of 0.3 g/kg glucose and 0.02 U/kg regular human insulin. The insulin sensitivity index (S(I)) was calculated using a computer program. RESULTS: The basal insulin/glucose ratio (I/G) and S(I) did not differ between the AGA and SGA groups. Steroids did not influence the I/G nor the S(I) of AGA infants (10.2 +/- 6.7 vs 8.2 +/- 2.3), but decreased the S(I) in the SGA group (12.2 +/- 5.1 vs 5.3 +/- 2.7, P <.05). CONCLUSIONS: Insulin sensitivity of neonates can be measured by the modified minimal model. IUGR is not associated with impaired fetal glucose tolerance. Early neonatal steroid treatment decreases insulin sensitivity in SGA infants, which may contribute to their risk of having hyperglycemia.     

早产小于胎龄儿生长代谢的临床研究

目的 探讨早产小于胎龄儿（SGA）与适于胎龄儿（AGA）在住院期间生长代谢的差异,为临床对早产SGA进行营养干预提供依据。方法 1 370例早产儿纳入研究,根据胎龄与出生体重的关系分为SGA组（675例）与AGA组（695例）,比较两组早产儿住院期间的一般情况、体格增长及血生化指标等情况。结果 SGA组住院天数长于AGA组（P < 0.05）。与AGA组相比,SGA组出院体重、出院体重Z评分及出院身长均较低,宫外生长迟缓发生率较高（P < 0.05）,头围增长速率大于AGA组。与AGA组相比,SGA组达全肠内喂养时间及需肠外营养时间均较长（P < 0.05）。SGA组入院时白蛋白、前白蛋白、血清磷、出院前总胆汁酸高于AGA组,白蛋白低于AGA组（P < 0.05）。SGA组窒息、新生儿呼吸窘迫综合征、心肌损伤、喂养不耐受、肺炎、败血症、低血糖、低甲状腺素血症的发生率高于AGA组（P < 0.05）。结论 早产SGA住院期间体格发育明显落后于AGA,宫外生长迟缓发生率较高,更易出现并发症。     

胎龄联合出生体重对新生儿遗传代谢病相关代谢物的影响

目的 探讨胎龄联合出生体重对遗传代谢病（IMD）相关代谢物的影响。方法 从2014~2016年间参加IMD筛查的38 931名新生儿中,随机抽取3381例经随访排除IMD疾病的新生儿样本,按胎龄联合出生体重分为极早产适于胎龄儿组（n=12）、早产小于胎龄儿组（n=18）、早产适于胎龄儿组（n=219）、早产大于胎龄儿组（n=18）、足月小于胎龄儿组（n=206）、足月适于胎龄儿组（n=2 677）、足月大于胎龄儿组（n=231）。采集各组新生儿出生3~7 d充分哺乳后的足跟血,采用串联质谱检测干血斑中17种IMD关键代谢指标水平。利用Spearman秩相关分析各影响因素与代谢指标的相关性,采用协方差分析各组代谢指标水平差异。结果 在控制了新生儿生理及病理状态等相关因素后,与足月适于胎龄儿组相比,亮氨酸\异亮氨酸\羟基脯氨酸、缬氨酸在极早产适于胎龄儿、早产小于胎龄儿、早产适于胎龄儿组,鸟氨酸在早产适于胎龄儿组,脯氨酸在极早产、早产适于胎龄儿组中水平明显下降（P < 0.05）;苯丙氨酸在极早产、早产适于胎龄儿组,甲硫氨酸在早产小于胎龄儿组,酪氨酸在早产适于胎龄儿组中水平则明显升高（P < 0.05）;游离肉碱、乙酰肉碱、丙酰肉碱在早产小于胎龄儿、早产适于胎龄儿组,十八碳烯酰肉碱在早产小于胎龄儿组中水平明显升高（P < 0.05）。大部分肉碱指标在早产和足月的小于胎龄儿分别与适于胎龄儿、大于胎龄儿组间比较中差异有统计学意义（P < 0.05）。结论 胎龄不足和低出生体重均会造成IMD筛查指标异常,故在判读IMD筛查指标异常时应结合胎龄和体重情况综合判断。     

Association between serum leptin and anthropometric parameters at birth and at 15th day of life in infants born asymmetrically small for gestational age

The aim of this study was to investigate changes in skinfold measurements taken at three sites, mid-arm circumference and umbilical circumference during the first 15 days of life; and to evaluate relationships between anthropometric measurements and umbilical cord blood serum leptin levels in infants born small for gestational age (SGA) and appropriate for gestational age (AGA) infants. Of 50 newborn infants, 25 were SGA and 25 were AGA. Neonates' weight, mid-arm circumference (MAC), umbilical circumference (UC), and triceps, subscapular and periumbilical skinfold thicknesses were measured (Holtain callipers) immediately after delivery. Anthropometric parameters were measured again at 15th days of age. At birth, mean birth weight, mean skinfold thickness, MAC and UC measurements in the AGA group were significantly higher than those of the SGA group. These differences were also found on the 15th day. Birth weight correlated with all skinfold thicknesses, MAC and UC at birth. Weight at 15th day of life correlated with skinfold thicknesses, MAC and UC at 15th day of life. Cord blood leptin level was significantly lower in the SGA than in the AGA infants. This difference continued on the 15th day. When cord blood leptin level was compared with that of the 15th day, we found that leptin levels in the cord blood were significantly higher. There were significantly positive correlations between leptin levels and birth weight and skinfold thicknesses when the infants were all grouped together. When the newborns were grouped according to birth weight, there were positive correlations between cord blood serum leptin levels and these parameters in the AGA group, but no correlation in the SGA group. At the 15th day of life serum leptin levels correlated with weight, subscapular and triceps skinfold thickness in the AGA group, but only with triceps skinfold thickness in the SGA group.     

CONCENTRATIONS OF TRIGLYCERIDES, FREE FATTY ACIDS AND GLYCEROL IN CORD BLOOD OF NEWBORN INFANTS WITH A BIRTH WEIGHT OF ≤2700 GRAMS

Abstract Concentrations of triglycerides, free fatty acids (FFA) and glycerol were measured in umbilical venous blood from 99 infants with a birth weight of between 1100–2700 g and a gestational age of 27–41 weeks. Thirty infants were small for gestational age (SGA), 58 were appropriate (AGA) and 11 were of uncertain gestational age. In AGA infants with a gestational age of ≥35 weeks, FFA values were lower than in those with a gestational age of>35 weeks; otherwise concentrations of triglycerides, FFA and glycerol were independent of birth weight and gestational age in AGA infants. In SGA infants, higher FFA values were found compared with both AGA and term infants of normal birth weight. Triglyceride values were higher in SGA than in AGA infants. In SGA infants, a significant positive correlation was found between gestational age and concentrations of both FFA and triglycerides. No differences in FFA, glycerol and triglyceride concentrations were seen between asphyxiated and non-asphyxiated AGA infants.     

小于胎龄儿婴儿期肺功能初步探讨

目的 比较小于胎龄儿（SGA）和适于胎龄儿（AGA）婴儿期肺功能的差异。方法 2010 年 7 月至 2013 年 7 月在深圳市儿童医院NICU住院的胎龄<36周、无明显影响肺功能疾病的SGA为SGA组;出生体重与SGA组匹配的AGA为AGA组。两组均于纠正胎龄12月龄随访时行潮气呼吸和功能残气量检测,比较两组肺功能参数的差异。多元线性回归分析SGA组影响小气道功能的因素。结果 SGA 组 20 例（男 12 例,女 8 例）,AGA 组 30 例（男 17 例,女 13 例）进入分析。两组在出生体重和身长,机械通气天数等基线数据差异无统计学意义（P>0.05）;SGA 组胎龄和用氧天数高于 AGA 组,SGA组随访时体重和身长均低于 AGA 组（P＜0.05）。①在纠正胎龄12 月龄随访时两组呼吸频率、潮气量、每公斤潮气量、分钟通气量和功能残气量的差异均无统计学意义（P>0.05）; 呼气达峰时间、呼气达峰容积、呼气达峰时间比、呼气达峰容积比,75%、50%和25%潮气量时呼气流速,SGA 组均低于 AGA 组（P＜0.05）。②两组NICU出院至肺功能检测期间下呼吸道感染≥3次的比例,SGA组为90%（18/20）,AGA组为50%（15/30）,差异有统计学意义。③多元线性回归显示,SGA组25%潮气量时呼气流速与检测肺功能随访时身长、体重呈正相关,与吸氧天数呈负相关。结论 SGA 婴儿期肺容积参数与出生体重相近的AGA相近,但气道阻力高于AGA,可能与SGA生后肺发育迟缓相关。     

脑源性神经营养因子与新生儿出生体重的关系

目的：该文通过检测新生儿脐血脑源性神经营养因子（brain-derived neurotrophic factor,BDNF）的水平,探讨BDNF与新生儿出生体重的关系,并对相关因素进行分析。方法：根据出生体重,将51 例足月第1胎健康新生儿分为3 组:①小于胎龄组（SGA）8例;②适于胎龄组（AGA ）31例;③大于胎龄组（LGA）12例。测量新生儿身长、体重及其母亲的身高、体重,并对脐血中BDNF、瘦素（LEP）、胰岛素（INS）、总胆固醇（TC）、甘油三酯（TG）进行检测。结果：SGA组的BDNF明显高于AGA组和大于LGA组,AGA组和LGA组中BDNF没有差异;多元逐步回归分析显示BDNF值与新生儿出生体重、体重指数存在负相关关系。LEP与BDNF不呈相关趋势（P>0.05）,INS与BDNF也不呈相关趋势（P>0.05）。INS 与LEP呈现正相关（P<0.05）。LEP与新生儿体重、产妇体重及其BMI呈正相关,而TC,TG在3组新生儿中差异无显著性。结论：BDNF是新生儿体重的重要影响因素,而且不受LEP,INS的影响。     

Increased energy expenditure and fecal fat excretion do not impair weight gain in small-for-gestational-age preterm infants.

In order to optimize the nutrition of high-risk premature infants beyond the early postnatal period, a more precise knowledge of individual nutritional requirements is needed. We therefore studied the influence of intrauterine growth retardation on energy expenditure and nutrient utilization determined by indirect calorimetry and fecal fat excretion (steatocrit) in nineteen premature infants who were appropriate-for-gestational-age (AGA; mean gestational age 29.9+/-0.3 weeks, mean birth weight 1.30+/-0.05 kg) and thirteen small-for-gestational-age (SGA) premature infants [mean gestational age 32.4+/-0.5 weeks, mean birth weight 1.024+/-0.07 kg (i.e., below the 10th percentile)] during the first and second month of life. All infants were clinically stable during the study period. In nine SGA infants we observed a significantly higher steatocrit compared to twelve AGA infants (29+/-1 vs. 17+/-1% p = 0.0001). SGA infants (n = 12) also showed a slightly (albeit statistically not significantly) higher energy expenditure than AGA infants (n = 15) (58.7+/-1.9 vs. 53.6+/-1.5 kcal/kg per day, p = 0.054). Despite the increased fat excretion and higher energy expenditure, SGA infants gained weight more rapidly during the study period than AGA infants (20+/-1 vs. 17+/-1 g/kg per day, p = 0.026). We conclude that influences of intrauterine growth retardation on energy expenditure and nutrient utilization persist during the first weeks of extrauterine life. However, these metabolic changes do not impair the capability of SGA infants for extrauterine catch-up growth if adequate nutrition is provided.     

Growth of premature infants fed own mother's milk supplied with two milk formulas

The purpose of the authors in this article was to evaluate the effects of supplementing maternal milk with two different caloric formulas on the growth of premature newborns until they reached 40 weeks of post-conceptional age. Seventy premature infants weighing < 1750g at birth were randomized: 35 adequate for gestational age (AGA) and 35 small for gestational age received maternal milk and either a special preterm formula or a modified formula. Anthropometric measurements and clinical evaluations were used to determine the nutritional status and the postnatal growth of these infants, who were analyzed in six different moments: at maximum weight loss, at return to birth weight, at definite weight gain, when exclusively fed with formula, at 2000g, and when they reached 40 weeks of post-conceptional age. The AGA premature newborns on preterm formula had greater daily weight gain, cephalic circumference increase and growth. The SGA premature newborns on preterm formula had greater daily weight gain and cephalic circumference increase observed from the third week of life onward. The AGA premature newborns on modified formula had less weight gain and smaller increments in the cephalic circumference. The SGA premature on modified formula had the worst anthropometric results. The preterm formula was more efficient than the modified formula in promoting postnatal growth of AGA and SGA premature infants. We believe that, due to their special characteristics, SGA premature should receive individualized nutritional caloric planning     

Serum adiponectin concentrations in newborn infants in early postnatal life

Serum adiponectin levels were investigated in 28 small-for-gestational-age (SGA) and 34 appropriate-for-gestational-age (AGA) term neonates to examine how fetal growth correlates with adiponectin levels. A blood sample for determination of adiponectin was obtained during the first 24 h of life. The levels of serum adiponectin were significantly higher in all newborn infants than in healthy children (28.7 +/- 17.0 versus 9.3 +/- 6.1 microg/mL; p < 0.01). There was a significant difference in adiponectin levels between SGA and AGA infants (23.2 +/- 14.8 versus 33.2 +/- 17.5 microg/mL; p=0.02). For all of the newborn groups, serum adiponectin levels correlated positively with birth weight (r=0.27, p <0.05) and head circumference (r=0.30, p <0.05). There was no relationship between serum adiponectin levels and gestational age, birth length, blood glucose levels, or blood sampling time after birth. There was no gender difference in adiponectin levels in the entire newborn group (30.0 +/- 19.7 versus 28.0 +/- 15.5 microg/mL, in male and female infants). Our results suggest that hyperadiponectinemia and a positive relationship between the serum levels of adiponectin and birth weight in newborns cannot be explained by the low percentage of body fat alone. Lower adiponectin levels in SGA infants than in AGA infants are unlikely to suggest insulin resistance in intrauterine growth-retarded infants in early postnatal life but may be a predisposing factor in the future development of insulin resistance or type 2 diabetes.     

Anthropometric assessment of nutritional status in newborn infants. Discriminative value of mid arm circumference and of skinfold thickness

74 appropriate-for-gestational age (AGA) and 22 small-for-gestational age (SGA) caucasian infants were studied for anthropometric parameters: mid arm circumference (MAC), triceps and subscapular skinfold thickness (TSKF and SSKF) recorded at 15 and 60 s, chest circumference (cc), head circumference, birth weight and length.MAC is highly correlated with birth weight either in AGA (r = 0.936; P < 0.001) or in SGA infants (r = 0.860; P < 0.001). MAC is also correlated with gestational age in AGA (r = 0.850; P < 0.001) and SGA infants (r = 0.76; P < 0.001). Similar correlations were found between TSKF, SSKF and birth weight or gestational age. Arm muscle and fat areas are also positively correlated with birth weight and gestational age, in AGA and SGA infants.A multiple regression analysis of our data allowed a classification of the best discriminant anthropometric parameters between AGA and SGA infants. MAC, SSKF15, SSKF60 and chest circumference were selected. An equation was established in AGA infants with these four parameters giving a predictive gestational age: gestational age (weeks) = 1.216 MAC (cm)?3.588 SSKF15 (mm)+0.263 CC (cm) + 17.9.The ratio of predicted gestational age to the real gestational age was 1.0 ± 0.044 in AGA versus 0.896 ± 0.034 in SGA infants.Our data suggest that MAC and SSKF provide a simple measure of body composition of neonates and a useful tool for determining the degree of maturity of a newborn independent of birth weight.     

成都市9~15岁儿童出生情况与体格指标流行病学调查

目的：宫内环境可能对儿童生长发育产生影响,通过流行病学调查研究四川省成都市9~15岁儿童出生胎龄、体重与体格发育指标的关系。方法：调查9~15岁的中小学学生共7194名,根据出生胎龄及体重对儿童进行分类（包括小于胎龄儿、适于胎龄儿、大于胎龄儿）,测量身高、体重,并对其家长进行问卷调查。结果：被调查人群小于胎龄儿发生率为6.23%（448例）,其中身高未出现“追赶生长”（低于均值两个标准差）为5.13%,且多个年龄段儿童平均身高低于适于胎龄儿（P<0.05）。大于胎龄儿发生率为18.06% (1299例),大于胎龄儿中超重发生率为13.78% (179 例),肥胖发生率为4.39%（57例）,且多个年龄段儿童平均体重大于适于胎龄儿（P<0.05）。结论：出生时为小于胎龄儿、大于胎龄儿的儿童在远期生长发育中,可以出现身高和体重异于正常儿童,应关注这类孩子在学龄期的身高体重发育情况。