脐血可溶性瘦素受体与胎儿生长发育关系探讨

目的：瘦素是肥胖基因的蛋白产物，除参与调节机体能量代谢外，与胎儿的生长发育密切相关，但其作用机制尚不清楚。本研究旨在探讨脐血可溶性瘦素受体与胎儿生长发育的关系及其可能机制。方法：67例足月新生儿根据出生体重分为小于胎龄儿(SGA)组23例，适于胎龄儿(AGA)组44例。采用ELISA法测定脐血和母血中瘦素及可溶性瘦素受体水平，并采用体脂含量估测新生儿营养状态。结果：①脐血可溶性瘦素受体水平与脐血瘦素水平及新生儿出生体重、体脂含量呈负相关(r分别为-0.405，-0.366，-0.356，P均0.05)。③SGA组脐血可溶性瘦素受体明显高于AGA组［(18.24±6.02) ng/ml vs (13.80±4.37) ng/ml］，P<0.01；而SGA组的瘦素含量低于AGA组［(6.79±4.59) ng/ml vs (16.30±11.62) ng/ml］，P<0.01。④脐血可溶性瘦素受体水平男性高于女性［(16.89±4.37) ng/ml vs (13.95±5.29) ng/ml］，P<0.05；而脐血瘦素水平则是男性低于女性［(10.28±8.28) ng/ml vs (15.70±12.11) ng/ml］，P<0.05。结论：可溶性瘦素受体可能通过对血清中游离瘦素水平的调节实现对胎儿生长发育的调控作用。同时测定瘦素和可溶性瘦素受体可能更有利于进一步了解瘦素的病理生理作用机制。

Relationship Between Soluble Leptin Receptor in Cord Blood and Fetal Growth and Development

OBJECTIVE: Leptin, the obesity gene product, plays a key role in the regulation of energy metabolism and is correlated with fetal growth and development, but the mechanisms are not clearly understood. This study aimed to explore the relationship between soluble leptin receptor (sOB-R) in cord blood and fetal growth and development. METHODS: According to the birth weight, 67 full-term newborns were divided into two groups; the small for gestational age group (SGA group, n = 23) and the appropriate for gestational age group (AGA group, n = 44). The levels of leptin and sOR-R were assayed by ELISA and the nutrional state of the newborns was evaluated with body fat content measured by the Weststrate formula. RESULTS: The sOB-R level in cord blood was negatively related to leptin in cord blood, birth weight and body fat content ( r = -0.405, -0.366, -0.356 respectively; all P <0.05) and it was not related to maternal leptin level and sOB-R. The sOB-R level in cord blood in the SGA group was significantly higher than that in the AGA group [(18.24±6.02) ng/ml vs (13.8014.37) ng/ml; P <0.01], whereas the leptin level in the SGA group was much lower than that in the AGA group [(6.79±4.59) ng/ml vs (16.30±11.62) ng/ml; P<0.01]. The sOB-R level in cord blood in male infants was higher than that in female ones [(16.8914.37) ng/ml vs (13.9515.29) ng/ml; P <0.05], but the leptin level in the former was lower than that in the latter [(10.2818.28) ng/ml vs (15.70 ±12.11) ng/ml; P <0.05]. CONCLUSIONS: sOB-R in cord blood may have effects on fetal growth and development by regulating the serum level of free leptin. Quantification of both circulating leptin and sOB-R levels may be more valuable for understanding the mechanism of leptin.