不同出生胎龄的2～7岁小于胎龄儿生长激素释放多肽、胰岛素样生长因子-1、胰岛素水平及其与生长发育的关系  

Relationship of plasma ghrelin,IGF-1 and insulin with the growth and development of 2-7 year-old children with small for gestational age at birth

作　　者：程亚颖[1] 宋光耀[1] 周利霞[2] 蔡宝萍[1] 赵秀勉[1] 尹建英[1] 

机构地区：[1]河北省人民医院儿科,石家庄050051 [2]河北省人民医院检验科

出　　处：《卫生研究》2012年第1期18-22,共5页Journal of Hygiene Research

基　　金：国家自然科学基金资助项目(No.30971391);河北省人口计生委科研计划课题(No.2011-A09)

摘　　要：目的探讨生长激素释放多肽（Ghrelin）、胰岛素样生长因子-1（IGF-1）、胰岛素样生长因子结合蛋白-3（IGFBP-3）、胰岛素在小于胎龄儿（SGA）生长发育中的作用。方法分别检测2～7岁早产SGA、足月SGA血Ghrelin、IGF-1、IGFBP-3、胰岛素、血糖的水平,并与相应的早产AGA、足月AGA进行比较,并做相关性分析。结果 Ghrelin在早产SGA组高于足月SGA（P〈0.05）,与早产AGA无明显差异,早产AGA高于足月AGA（P〈0.05）,足月SGA高于足月AGA（P〈0.01）。IGF-1和IGFBP-3水平在早产SGA组低于足月SGA（P〈0.05）,早产AGA组明显低于足月AGA组（P〈0.0001）。胰岛素水平在足月SGA组最高。胰岛素抵抗指数（IRI）在各组间比较与胰岛素结果一致。早产SGA组与足月SGA组中Ghrelin与各项指标的相关分析显示：Ghrelin与体重标准差计分（SDS）、IGF-1、IGFBP-3、胰岛素及IRI呈负相关,早产SGA组分别为（r=-0.683,P〈0.002;r=-0.749,P〈0.001;r=-0.828,P〈0.001;r=-0.694,P〈0.005;r=-0.822,P〈0.001）,足月SGA组分别为（r=-0.792,P〈0.001;r=-0.707,P〈0.002;r=-0.615,P〈0.01;r=-0.648,P〈0.005;r=-0.679,P〈0.005）。结论 Ghrelin参与了早产儿和SGA儿生后的生长发育过程,但与追赶生长程度的关系不大。Ghrelin作为胰岛素的反调节因子,以负反馈的形式调节能量代谢。Objective To explore the relationship of Ghrelin,insulin-like growth factor-1（IGF-1） and insulin with the growth and development of 2-7 year-old children with small for gestational age（SGA） at birth.Methods The levels of ghrelin,IGF-1,IGFBP-3,insulin and glucose were measured in the children with preterm SGA and term SGA and compared with the children with preterm appropriate for gestational age（AGA） and term AGA.The correlation of ghrelin with IGF-1,IGFBP-3 and insulin was analyzed.Results Plasma ghrelin in preterm SGA was higher than that in term SGA（P0.05）,and there was no significant difference between preterm SGA and preterm AGA（P0.05）.Plasma ghrelin in preterm AGA and term SGA was higher than that in term AGA（P0.05,P0.01 respectively）.Serum IGF-1 and IGFBP-3 in preterm SGA were lower than those in term SGA（P0.05 for all） and serum IGF-1 and IGFBP-3 in preterm AGA were much lower than those in term AGA（P0.0001 for all）.The level of serum insulin was the highest in term SGA.The trend of insulin resistance index（IRI） was similar to insulin.There were negative correlations of ghrelin with other indexes（weight SDS,IGF-1,IGFBP-3,insulin and IRI） in preterm SGA and term SGA（in preterm SGA r=-0.683,P0.002;r=-0.749,P0.001;r=-0.828,P0.001;r=-0.694,P0.005;r=-0.822,P0.001;in term SGA r=-0.792,P0.001;r=-0.707,P0.002;r=-0.615,P0.01;r=-0.648,P0.005;r=-0.679,P0.005）.Conclusion Ghrelin is involved in the regulation of growth and development of preterm and SGA children,regardless of the magnitude of their catch up growth.As a re-regulatory factor to insulin,ghrelin regulates the energy metabolism in a form of negative feedback.

关 键 词：小于胎龄儿 生长发育 生长激素释放多肽 胰岛素样生长因子 胰岛素 

分 类 号：Q575.11[生物学—生物化学]