小于胎龄儿新生儿期ghrelin水平与生长轴关系的研究

目的通过比较小于胎龄儿（SGA）与适于胎龄儿（AGA）新生儿早期血ghrelin水平和代谢促生长轴各因素的差别和相关性，探索ghrelin在SGA发病机制中的作用。方法通过配对对17例SGA和17例AGA的血清ghrelin、IGF-1、生长激素、胰岛素、血糖浓度进行比较并分析其差异的意义。结果与AGA组相比，SGA组血ghrelin水平显著升高（P〈0．05），血IGF-1、胰岛素水平显著下降（P〈0．05），血生长激素和血糖水平差异无统计学意义。结论与AGA相比，SGA新生儿有高ghrelin血症。SGA新生儿的高血ghrenlin水平伴随其低下的出生体重、身长、血IGF-1、胰岛素水平，在一定程度上反映了其宫内营养不良状况。ghrelin作为胰岛素的反调节激素，SGA的ghrelin高分泌可能是宫内能量负平衡所致低胰岛素、低IGF-1状态反馈和／或重整性调控的结果。

Relationship between ghrelin level and growth axis of small for gestational age newborns

Objectives To study the role of ghrelin in small for gestational age newborns(SGA)by comparing the difference and correlation of ghrelin level and growth axis in SGA newborns with that of adapt to gestational age(AGA)newborns.Methods Blood sugar,insulin,growth hormone,IGF-1 and ghrelin level in 17 SGA newborns and 17 normal controls(AGA newborns)were measured and the significance of the difference was analyzed.Results Ghrelin level increased remarkably in SGA group as compared with that of AGA group(P < 0.05).In contrast,IGF-1 and insulin level was lower in SGA group(P < 0.05).There was no difference in growth hormone and glycemia levels between two groups.Conclusions As compared with AGA,SGA have higher ghrelin level.This increaes in ghrenlin level is inversely related to weight,height,IGF-1 and insulin level,which may reflect the status of intrauterine malnutrition.Ghrelin,as a inverse regulator of insulin,may be increased as a result of energy negative balance induced low insulin level and low IGF-1 level and/or the result of the reforming adjustment.