孕晚期糖脂代谢与子代出生体质量及早期生长发育的相关性研究  

Relationships of Glucose and Lipid Metabolism in Third Trimester with Offspring Birth Weight and Early Growth Development

作　　者：林穗青[1] 张丹[2] 吴巧玲[2] 彭咏梅[2] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院产科,上海200030 [2]复旦大学附属儿科医院儿童保健科,上海201102

出　　处：《中国临床医学》2014年第2期196-199,共4页Chinese Journal of Clinical Medicine

基　　金：国家科技部十一五支撑计划项目(编号:2009BAI80B03)

摘　　要：目的：探讨孕晚期母血及脐血糖脂代谢与子代出生体质量及早期生长发育的关系。方法：随机选择950例母子配对样本，检测孕36-38周母血及脐血中血糖（glucose，Glu）、胰岛素、C-肽（C-peptide，C-P）、三酰甘油（triglycerides，TG）、总胆固醇（total cholesterol，TC）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL—C）及低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）；采集母亲孕期及婴儿出生时的一般资料以及婴儿出生后42d、3月、6月、9月及12月龄的来院体检资料。结果：（1）低出生体质量（low birth weight，LBW）、正常出生体质量（normal birth weight，NBW）及高出生体质量（high birth weight，HBW）组新生儿间母血、脐血的LDL-C、胰岛素及C—P含量差异有统计学意义；其中LBW组LDC—C含量显著高于NBw组，HBw组胰岛素含量、C—P含量显著高于NBW组。（2）孕晚期母血与脐血的TG、TC、HDL—C、LDL-C、Glu、胰岛素及C-P含量均呈正相关（P〈0．01）。（3）孕晚期母血及脐血TG与婴儿42d年龄别体质量Z分值（weight—for-age Z-score，WAz）、体质量指数Z分值（body mass index Z—score，ZBMI）、年龄别身长Z分值（1ength—for-age Z—score，LAz）呈负相关，与婴儿3、6、9、12月龄WAZ、身长别体质量Z分值（weight—for—length Z-score，WLZ）、zBMI呈负相关；LDL—C与婴儿42d LAZ、WAZ及3月龄LAZ呈负相关；C—P含量与婴儿42d LAZ及6月龄LAZ呈正相关。结论：母血及脐血高LDL—C、TG易致新生儿LBW，而高C-P则可导致新生儿HBW；母血及脐血高TG、LDL-C、C-P水平是新生儿体格生长的不利因素。Objective：To study the correlation among glucose and lipid metabolism in maternal blood and umbilical cord blood in third trimester and the offspring birth weight and early growth development. Methods： A total of 950 mothers and their offspring were randomly selected. Maternal blood and umbilical cord blood during 36 to 38 weeks of pregnancy were detected to evaluate the concentration of glucose （ Glu）, insulin, C-Peptide （C-P）, triglycerides （TG）, total cholesterol （ TC）, high density lipoprotein cholesterol（HDL-C） and low density lipoprotein cholesterol（LDL-C）. The clinical datum of mothers during pregnan- cy and their offspring after birth were recorded. At 42 days,3,6,9,12 months,infants were brought to Children＇s hospital to do anthropometric measurement. Results： （1）LDL-C,insulin and C-P concentrations had significant differences in infants with low birth weight（LBW）,normal birth weight（NBW） and high birth weight（HBW）. The concentration of LDL-C in LBW group was significantly higher than that in NBW group. The concentrations of insulin and C-P in HBW group were significantly higher than those in NBW group. （2）There was a significant linear positive correlation between concentrations of TG,TC, HDL-C, LDL-C, Glu,insulin and C-P in maternal blood and umbilical cord blood （P〈0.01）. （3）TG in maternal blood and umbilical cord blood had negative correlation with weight-for-age Z-score（WAZ）, body mass index Z-score （zBMI） and length-for-age Z-score （LAZ） of infants at 42 days and WAZ, weight-for-length Z-score（WLZ）, zBMI of infants at 3,6,9,12 months; LDL-C had negative correlation with LAZ, WAZ at 42 days and LAZ at 3 month; C-P had positive correlation with LAZ at 42 days and LAZ at 6 months. Conclusions： The high levels of TG, LDL-C in maternal blood and umbilical cord blood may cause LBW in infants, and the high C-P level may cause HBW in infants. And the high levels of TG, LDL-C in maternal blood and umbilical cord blood are the ne

关 键 词：出生体质量 糖脂代谢 婴儿 体格生长 

分 类 号：R715[医药卫生—妇产科学]