Ong K K, Ahmed M L, Sherriff A, Woods K A, Watts A, Golding J, Dunger D B
University Department of Paediatrics, John Radcliffe Hospital, Oxford, UK.
J Clin Endocrinol Metab. 1999 Mar;84(3):1145-8. doi: 10.1210/jcem.84.3.5657.
Recent discoveries of human genetic leptin deficiency have demonstrated its importance in regulating weight gain in early childhood. To investigate whether normal variation in leptin and insulin levels in cord blood could influence infancy growth, we assayed samples from 197 infants from a representative birth cohort, who were measured at birth, 4, 8, 12 and 24 months. Cord leptin levels correlated most closely with weight and ponderal index (kg/m3) at birth, but also with length and head circumference (all p<0.0005). Independent of birth size, females had higher leptin levels than males (p<0.0005). Cord levels of leptin, but not insulin, were negatively related to weight gain (p<0.005) from birth to 4 months, and accounted for 9.4% of the variance in weight gain, compared with breast/bottle feeding (3.5%) and early/late introduction of solids (1%). The effect of leptin levels on weight gain was independent of birthweight, and was still evident at 24 months. The wide variation in infancy growth ('catch-up' or 'catch-down') may be partly determined by leptin levels preset in utero. Our data support a role for leptin in the regulation of infancy weight gain, and suggest a mechanism whereby infants may 'catch-up' in growth postnatally following an adverse intrauterine environment.
近期关于人类遗传性瘦素缺乏症的发现已证明其在调节幼儿期体重增加方面的重要性。为了研究脐带血中瘦素和胰岛素水平的正常变异是否会影响婴儿期生长，我们对来自一个具有代表性的出生队列的197名婴儿的样本进行了检测，这些婴儿在出生时、4个月、8个月、12个月和24个月时接受了测量。脐带瘦素水平与出生时的体重和 ponderal 指数（kg/m3）最为密切相关，但也与身长和头围相关（所有p<0.0005）。独立于出生大小，女性的瘦素水平高于男性（p<0.0005）。从出生到4个月，脐带瘦素水平而非胰岛素水平与体重增加呈负相关（p<0.005），并且在体重增加的方差中占9.4%，相比之下母乳喂养/奶瓶喂养占3.5%，固体食物的早/晚引入占1%。瘦素水平对体重增加的影响独立于出生体重，并且在24个月时仍然明显。婴儿期生长的广泛差异（“追赶”或“追赶不足”）可能部分由子宫内预设的瘦素水平决定。我们的数据支持瘦素在调节婴儿期体重增加中的作用，并提出了一种机制，通过该机制婴儿在子宫内环境不利后可能在出生后“追赶”生长。
