IGF-1、IGFBP-3与极低出生体质量儿生后早期生长发育的关系

摘要

Objective To explore the relationships of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) with growth of very low birth weight (VLBW) infants in the early postnatal stage. Methods According to the individual gestational age and birth weight, 32 cases of VLBW infants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. After birth, all the infants were given the same nutritional intake. The body weight, body length, head circumference and body mass index (BMI) were monitored at different time points (d0, d7, d14 and d28 after birth). Serum IGF-1 and IGFBP-3 levels were measured by radiommunoassay, and IGF-1/IGFBP-3 molar ratio was calculated. Results There was no signiifcant difference of body weight, body length, head circumference and BMI between two groups at d0, d7, d14 after birth. Body weight and BMI in SGA group were less than those in AGA group at d28 after birth (P<0.05). The levels of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in SGA group and IGF-1/IGFBP-3 in AGA group did not change with age after birth. The levels of IGF-1 and IGFBP-3 were increased in AGA group after birth. The level of IGF-1 in AGA group at d14 and d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The level of IGFBP-3 in AGA group at d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The levels of IGF-1 and IGFBP-3 in SGA group at d28 after birth were lower than those in AGA group at d28 after birth (P<0.05). Conclusions Serum IGF-1 and IGFBP-3 levels in SGA group are lower than those in AGA group. Low levels of IGF-1 and IGFBP-3 may result in growth retardation.%目的：探讨胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)与早产极低出生体质量儿(VLBW)生后早期生长的关系。方法根据胎龄和出生体质量，将32例VLBW新生儿分为小于胎龄儿(SGA)组和适于胎龄儿(AGA)组，给予相同的营养摄入量，监测两组出生时和生后第7、14、28天时的体质量、身长、头围和体质指数(BMI)，并用放射免疫分析法检测相应日龄的血清IGF-1、IGFBP-3水平，计算IGF-1/IGFBP-3摩尔比率。结果两组VLBW新生儿在出生时及生后第7、14天的体质量、身长、头围、BMI差异均无统计学意义；至生后第28天时，SGA组的体质量、BMI均低于AGA组，差异有统计学意义(P<0.05)。SGA组IGF-1、IGFBP-3、IGF-1/IGFBP-3以及AGA组IGF-1/IGFBP-3出生后随日龄变化的差异无统计学意义(P均>0.05)；但AGA组的IGF-1、IGFBP-3水平随日龄增长而升高，IGF-1于生后第14、28天时高于出生时水平，而IGFBP-3于生后第28天时高于出生时水平，差异有统计学意义(P均<0.05)。生后第28天，SGA组IGF-1、IGFBP-3均低于AGA组，差异有统计学意义(P<0.05)。结论 SGA新生儿的IGF-1、IGFBP-3水平低于AGA，低水平的IGF-1、IGFBP-3可能会导致生长迟缓。