胰岛素样生长因子及胰岛素样生长因子结合蛋白-3与胎儿生长受限的关系

目的　探讨胰岛素样生长因子 (IGF) Ⅰ、IGF Ⅱ和IGF结合蛋白 3(IGFBP 3)与胎儿生长的关系 ,以及IGF在胎儿生长受限 (FGR)发病中的作用。方法　选取 2 0例分娩FGR胎儿 (FGR组 )、10例分娩巨大儿 (巨大儿组 )及 2 0例分娩正常儿 (对照组 )的产妇 ,抽取 3组产妇分娩后肘静脉血及其新生儿脐静脉血 ,分离血清。采用放射免疫法和免疫放射法测定 3组产妇及其新生儿血清中IGF Ⅰ、IGF Ⅱ及IGFBP 3的水平。结果　 (1)FGR组产妇血清IGF Ⅰ、IGF Ⅱ及IGFBP 3水平分别为(130 5± 2 6 0 ) μg/L、(2 40± 0 42 ) μg/L及(5 5 79± 848) μg/L ;新生儿脐血清IGF Ⅰ、IGF Ⅱ及IGFBP 3水平分别为 (6 6± 1 7) μg/L、(1 5 4± 0 31) μg/L及 (86 9± 183) μg/L。 (2 )巨大儿组产妇血清IGF Ⅰ、IGF Ⅱ及IGFBP 3水平分别为 (30 9 7± 44 6 ) μg/L、(2 43± 0 2 5 ) μg/L及(5 5 6 2± 742 ) μg/L ;新生儿脐血清IGF Ⅰ、IGF Ⅱ及IGFBP 3水平分别为 (6 9 6± 2 3 9) μg/L、(2 19± 0 2 9) μg/L及(16 82± 130 )μg/L。(3)对照组产妇血清IGF Ⅰ、IGF Ⅱ及IGFBP 3水平分别为 (30 7 9± 70 7) μg/L、(2 41± 0 36 )μg/L及 (5 5 86± 6 78) μg/L ;新生儿脐血清IGF Ⅰ、IGF Ⅱ及IGFBP 3水平分别为 (6 8 9

A study on the relationship between insulin-like growth factor, insulin-like growth factor-binding protein-3 and fetal growth retardation

OBJECTIVE: To explore the effect of insulin-like growth factor-I (IGF-I), insulin-like growth factor-II (IGF-II) and insulin-like growth factor-binding protein-3 (IGFBP-3) on the fetal growth. METHODS: Samples of maternal blood and matched umbilical cord blood were collected at time of delivery from twenty pairs of mothers and newborns with normal birth weight (control group) twenty pairs with fetal growth restriction (FGR group) and ten pairs with macrosomia (macrosomia group). Serum IGF-I, IGF-II and IGFBP-3 were measured by radioimmunoassay (RIA) and immunoradiometric analysis (IRMA). RESULTS: (1) Levels of maternal serum IGF-I, IGF-II and IGFBP-3 in GFR group were (130.5 +/- 26.0) microgram/L, (2.40 +/- 0.42) microgram/L, (5 579 +/- 848) microgram/L respectively; IGF-I, IGF-II and IGFBP-3 levels of fetal serum in this group were (6.6 +/- 1.7) microgram/L, (1.54 +/- 0.31) microgram/L, (869 +/- 183) microgram/L respectively. (2) In macrosomia group the levels of maternal serum IGF-I, IGF-II and IGFBP-3 were (309.7 +/- 44.6) microgram/L, (2.43 +/- 0.25) microgram/L, (5 562 +/- 742) microgram/L respectively. In fetal serum that were (69.6 +/- 23.9) microgram/L, (2.19 +/- 0.29) microgram/L, (1 682 +/- 130) microgram/L respectively. (3) In control group the levels of maternal serum IGF-I, IGF-II and IGFBP-3 were (307.9 +/- 70.7) microgram/L, (2.41 +/- 0.36) microgram/L, (5 586 +/- 678) microgram/L respectively;That were (68.9 +/- 32.9) microgram/L, (1.95 +/- 0.26) microgram/L, (1 624 +/- 296) microgram/L in fetal serum respectively. (4) In three group the levels of maternal IGF-I, IGF-II and IGFBP-3 were significantly higher than that of fetal levels (P < 0.01). The fetal IGF-I, IGF-II and IGFBP-3 levels in FGR group were significantly lower than those in control group (P < 0.01). (5) The levels of fetal IGF-I, IGF-II, IGFBP-3 were positively correlated with birth weight (r = 0.61, r = 0.51 and 0.63, P < 0.01) and placental weight (r = 0.47, r = 0.56 and 0.48, P < 0.01). The levels of fetal IGF-I, IGF-II and IGFBP-3 were no different between macrosomia group and control group. CONCLUSIONS: This study suggest that (1) IGF-I, IGF-II and IGFBP-3 cannot pass through the placenta. (2) The betal IGF-I, IGF-II and IGFBP-3 may have the close relationship with the fetal growth. The decrease of IGF-I, IGF-II and IGFBP-3 may be one of the causes of FGR.