IGF-1、IGF-2、IGFBP-3与非糖尿病孕妇巨大儿发生的相关性研究

目的探讨胰岛素样生长因子1、2（IGF-1、IGF-2）、胰岛素样生长因子结合蛋白3（IGFBP-3）与非糖尿病孕妇巨大儿发生的关联性。方法选择2010年1月至2011年5月于上海市浦东新区人民医院产前检查并分娩的初产妇,孕期纵向观察,抽取妊娠中期（26～28周）和妊娠足月（38～41周）的母血及孕妇分娩时新生儿出生体重≥4000g30例（巨大儿组）、2500～3500g30例（正常组）的脐血,应用放射免疫法检测IGF-1、IGF-2、IGFBP-3的水平,并进行对比分析。结果①两组孕妇妊娠足月IGF-1水平均高于妊娠中期,差异有高度统计学意义（分别为P〈0.0001、P〈0.001）,但妊娠中期和足月时,巨大儿组与正常组二组间比较差异均无统计学意义（P〉0.05）。巨大儿组脐血IGF-1水平高于正常组,差异有高度统计学意义（P〈0.0001）;②孕妇血清IGF-2水平巨大儿组与正常组比较差异无统计学意义（P〉0.05）;③孕妇妊娠中期、妊娠足月血清IG-FBP-3水平巨大儿组明显高于正常组,差异有高度统计学意义（分别为P〈0.001、P〈0.01）;④母血IGFBP-3水平、脐血IGF-1水平与新生儿出生体重正相关。结论 IGF-1参与了胎儿生长发育的调节;胎儿自身循环中的IGF-1与新生儿出生体重有关;非糖尿病孕妇血清IGFBP-3水平与巨大儿形成有关。

The relationship of macrosomia and insulin-like growth factor-Ⅰ (IGF-Ⅰ), insulin-like growth factor-Ⅱ (IGF-2), IGF binding protein-3 (IGFBP-3)

Objective To explore the relationship between fetal macrosomia of non-diabetic pregnancy (MNDP) and insulin-like growth factor-I (IGF-I), insulin-like growth factor-II (IGF-2), IGF binding protein-3 (IGFBP-3) .Methods This was a prospective , observational study of primipara who were prenatal cared and labored in People’s hospital of Pudong new area.Maternal venous serum samples were collected in week 26～28and week 38-41while the umbilical cord blood serums were collected after delivery.Levels of IGF-I , IGF-II and IGFBP3 were measured in macrosomia group (birth weight≥4 000g) and control group (birth weight 2 500～3 500g) by enzyme linked immunosorbent assay.Results ① The level of IGF-1 in maternal serum was increased following the pregnancy extended and was higher in full-term pregnancy , but had no significantly difference between the two groups (P>0.05) .While in cord blood , level of IGF-1 of macrosomia group was higher than that of control group (P<0.000 1) .② There was no statistical difference of IGF-2 level in thaternal serum between the two groups (P >0.05 ) .③ The levels of IGFBP3 of macrosomia group in full-term pregnancy and mid-pregnancy were significantly higher than that of control group (P<0.001 , P<0.01) .④ The level of IGFBP-3 in maternal blood and IGF-1 in cord blood were positive corretorted with the newborn’s weight.Conclusions IGF-1involved in the fetal growth and development Concentration of IGF-1 in fetal circulation may close related to newborn’s weight.High level of IGFBP3 may be one of the cause of macrosomia in non-diabetic pregnancy.