妊娠期糖尿病孕妇新生儿脐血脂联素水平及其与胎儿生长发育的相关性研究  

Cord blood concentration of adiponectin and its association with fetal development in term neonates with mothers of gestational diabetes

作　　者：周桂菊[1] 陶瑞雪[1] 李新玲[1] 郑重[2] 牛玉伟[1] 

机构地区：[1]合肥市第一人民医院妇产科,230061 [2]合肥市第一人民医院核医学科

出　　处：《中华临床医师杂志（电子版）》2011年第17期4971-4975,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：安徽医科大学校科研基金项目(2010XKJ109)

摘　　要：目的了解妊娠期糖尿病(GDM)孕妇新生儿脐血脂联素(APN)水平的变化,探讨脐血APN的来源及其与胎儿宫内生长发育的关系。方法采用酶联免疫吸附实验(ELISA)测定30例GDM孕妇和30例正常糖耐量(NGT)孕妇空腹血清及其新生儿脐血APN浓度,同时测定18例出生3d的新生儿血清APN水平。结果 (1)GDM组孕妇血清APN水平明显低于NGT组[分别为(1.946±1.477)ng/ml和(3.049±1.788)ng/ml],差异有统计学意义(P<0.05),但她们的新生儿脐血APN水平相比差异无统计学意义[分别为(4.318±1.993)ng/ml和(5.120±1.878)ng/ml](P>0.05)。(2)两组新生儿脐血APN水平均明显高于其母血APN水平,差异有统计学意义(P<0.01)。(3)新生儿出生时的脐血APN水平与其生后3d的血清APN水平相比差异无统计学意义(P>0.05)。(4)相关分析结果显示,两组新生儿脐血APN与其出生体重、出生体重指数(BMI)及孕龄均呈显著正相关(r分别为0.581、0.567、0.439和0.449、0.488、0.547,t分别为3.775、3.664、2.586和2.660、2.956、3.456,P<0.01或P<0.05),而与其母血APN及母体BMI无明显相关性(r分别为0.107、0.226和0.244、0.016,t分别为-0.570、1.228和1.330、0.563,P>0.05)。结论 (1)GDM孕妇血APN水平明显降低,但其新生儿脐血APN水平无明显变化。(2)脐血中高浓度的APN并非来自母体或胎盘,而是由胎儿自身组织分泌。(3)脐血APN可能参与调控宫内胎儿的生长发育。Objective To examine whether adiponectin has change in umbilical blood at delivery with mothers of gestational diabetes,to determine the source of cord blood adiponectin and whether there are correlations between adiponectin and fetal development.Methods The study included 30 women with GDM and 30 healthy pregnant women and all of their newborns at delivery and 18 of their neonates at 3 days postpartum.Adiponectin levels in maternal serum and umbilical cord serum and neonatal serum were measured by ELISA and compared.Results(1)Significantly decreased serum APN concentration was found in the women with GDM [(1.946±1.477)ng/ml] as compared with the healthy pregnant women [(3.049±1.788)ng/ml](P<0.05).But there was no significant difference of adiponectin levels in cord blood among their newborns [(4.318±1.993)ng/ml vs.(5.120±1.878)ng/ml,P>0.05].(2)Adiponectin levels in umbilical serum were significantly higher than those in maternal serum in GDM group [(4.318±1.993)ng/ml vs.(1.946±1.477)ng/ml,P<0.01] and in NGT group [(5.120±1.878)ng/ml vs.(3.049±1.788)ng/ml,P<0.01].(3)In the two groups,cord blood and 3 days postpartum serum adiponectin levels did not differ significantly(P>0.05).(4)Univariate linear correlation and regression analysis showed some statistically significant positive correlations between umbilical serum adiponectin levels and neonatal birthweights(r=0.581 and 0.449,P<0.01 and P<0.05)and BMI(r=0.567 and 0.488,P<0.01)and gestational ages at birth(r=0.439 and 0.547,P<0.05 and P<0.01),but cord blood adiponectin levels did not correlate with maternal serum adiponectin levels(r=0.107 and 0.244,P>0.05)and maternal BMI(r=0.226 and 0.016,P>0.05)in the two groups.Conclusions(1)The serum adiponectin levels in the GDM patients decrease significantly,but there is no change of adiponectin levels in their newborns cord blood.(2)The high cord adiponectin levels is derived from fetal and not from placental or maternal tissues.(3)Fetal adiponectin,not maternal serum adiponectin,may be involved in fetal developm

关 键 词：脂联素 糖尿病 妊娠 胚胎发育 

分 类 号：R714.2[医药卫生—妇产科学]