胰岛素样生长因子1及胰岛素样生长因子结合蛋白3与胎儿生长发育的关系

目的:探讨胰岛素样生长因子1（IGF-1）及胰岛素样生长因子结合蛋白3（IGFBP-3）与胎儿生长发育的关系。方法:应用酶联免疫吸附试验（LISA）测定26例正常妊娠（正常组）,42例妊娠期糖尿病（GDM组）,20例胎儿宫内发育迟缓（IUGR组）孕妇足月剖宫产分娩时,母血与脐血中IGF-1及IGFBP-3的水平,同时记录3组孕妇的新生儿出生体重。结果:（1）母血IGF-1及IGFBP-3的水平正常组分别为18 6.81μg/L、22.82μg/L,GDM组为283.35μg/L、28.29μg/L,IUGR组为220.64μg/L、25.23μg/L,3组间 IGF-IN IGFBP.3水平差异均无显著性（P>0.05）;（2）脐血IGF-1及IGFBP-3的水平正常组分别为62.54μg/L、8.56μg/L,GDM组分别为83.74μg/L、10.21μg/L,IUGR组为37.94μg/L、7.82μg/L,分别进行3组间两两比较,3组IGF-1及IGFBP-3的差异均有显著性（P<0.01）;（3）新生儿平均出生体重正常组为3.22±0.32kg,GDM组为3.76±0.43kg,IUGR组为2.41±0.17kg,3组间两两比较,差异均有显著性（P<0.01）;（4）3组脐血IGF-1及IGFBP-3水平与新生儿出生体重均有显著性正相关（P<0.01）;（5）3组母血及脐血的IGF-1与IGFBP-3均呈显著性正相关（P<0.01）。结论:来自胎儿循环的IGF-1、IGFBP-3对胎儿的生长发育有重要的调节作用,可能参与巨大儿及IUGR的病

The effect of insulin-like growth factor 1 and insulin-like growth factor -binding protein-3 on fetal growth

ve:To explore the role of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor -binding protein-3 (IGFBP-3) in the process of fetal growth. Methods: The study groups included 26 normal pregnant women (normal group) ,42 pregnant women with gestational dia-betes mellitus (GDM group) and 20 pregnant women with intrauterine growth retardation (IUGR group). The fetuses of the three groups were all born at full term and their birth weight were record-ed . Maternal venous blood samples were collected from all cases before cesarean section. Umbilical venous blood samples were collected at time of operation. The concentrations of IGF-1 and IGFBP-3 were assayed by ELISA. Results: (1)The levels of maternal serum IGF-1 and IGFBP-3 in normal group were 186.81μg/L,22.82μg/L, in GDM group were 283.35μg/L,28.29μg/L, in IUGR group were 220.64μg/L,25.23μg/L,and there were no significant differences among the three groups (P > 0.05) ; (2) The levels of umbilical serum IGF-1 and IGFBP - 3 in normal group were 62.54μg/L , 8.56μg/L,in GDM group were 83.74μg/L,10.21μg/L,in IUGR group were 37.94μg/L,7.82μg/L, and significant differences were exist among the three groups and in every two group (P < 0.01); (3) The newborn mean birth weight in normal group was 3.22±0.32 kg, in GDM group was 3.76±0.43kg,in IUGR group was 2.41±0.17kg,and significant differences exist among the three groups and in every two group,(P<0.01);(4)There was positive correlation between newborn birth weight and the umbilical serum IGF-1, IGFBP-3 in the three group (P < 0.01); (5)There was positive cor-relation between the maternal serum IGF-1 and IGFBP-3 in the three groups as well as in the umbili-cal serum (P<0.01). Conclusions: The changes of IGF-1 and IGFBP-3 of fetal circulation mayplay an important role in the fetal growth, and have a part in the pathophysiological process that re-sult in macrosomia or IUGR.The level of IGF-1 correlate with IGFBP-3 in the third-trimester.