Groenen Pascal M W, Wevers Ron A, Janssen Fokje S M, Tuerlings Joep H A M, Merkus Johannes M W M, Steegers-Theunissen Régine P M
Department of Epidemiology and Biostatistics, University Medical Center Nijmegen, 6500 HB Nijmegen, The Netherlands.
Early Hum Dev. 2003 Feb;71(1):1-8. doi: 10.1016/s0378-3782(02)00040-3.
Associations are reported between myo-inositol, glucose, zinc and the occurrence of spina bifida. To gain more insight into the pathogenesis of spina bifida, the concentrations of myo-inositol, glucose and zinc were determined in amniotic fluids from pregnancies with a spina bifida or unaffected control fetus.
Amniotic fluids of 27 pregnancies complicated by spina bifida and 49 controls were collected at the Department of Obstetrics and Gynecology of the University Medical Center Nijmegen in the Netherlands. Myo-inositol, glucose and zinc concentrations were determined. By indication, the samples were taken at different gestational ages. Therefore, the data were evaluated using multiple linear regression analysis to adjust for gestational age.
Amniocentesis was performed at a more advanced gestational age in the spina bifida group than in controls. In the spina bifida group, amniotic fluid myo-inositol, glucose and zinc concentrations gradually declined throughout pregnancy. At a gestational age of 15 weeks, the estimated mean amniotic fluid glucose and zinc concentrations in the spina bifida group were, respectively, significantly lower (p< or =0.5) and higher (p< or =0.5) compared with the control group. At the same gestational age, the estimated mean myo-inositol concentrations were comparable in both groups. At a gestational age of 38 weeks, the estimated mean myo-inositol, glucose and zinc concentrations were not significantly different in the spina bifida compared with the control group.
This study may suggest that a derangement in zinc and glucose transfer or metabolism is associated with spina bifida. Since compounds in amniotic fluid are only a very crude marker of the actual fetal condition, studies that focus on the metabolism of these compounds on tissue or even cellular level should be performed to clarify their role in the pathogenesis and future prevention of spina bifida.
据报道，肌醇、葡萄糖、锌与脊柱裂的发生之间存在关联。为了更深入了解脊柱裂的发病机制，对患有脊柱裂胎儿或未受影响的对照胎儿的妊娠羊水中肌醇、葡萄糖和锌的浓度进行了测定。
在荷兰奈梅亨大学医学中心妇产科收集了27例合并脊柱裂妊娠的羊水和49例对照羊水。测定了肌醇、葡萄糖和锌的浓度。根据指征，样本在不同孕周采集。因此，使用多元线性回归分析对数据进行评估，以校正孕周。
脊柱裂组羊水穿刺的孕周比对照组更晚。在脊柱裂组中，整个孕期羊水肌醇、葡萄糖和锌的浓度逐渐下降。在孕15周时，脊柱裂组羊水葡萄糖和锌的估计平均浓度分别显著低于（p≤0.5）和高于（p≤0.5）对照组。在相同孕周时，两组的估计平均肌醇浓度相当。在孕38周时，脊柱裂组与对照组相比，估计平均肌醇、葡萄糖和锌浓度无显著差异。
本研究可能提示锌和葡萄糖转运或代谢紊乱与脊柱裂有关。由于羊水中的化合物只是实际胎儿状况的一个非常粗略的标志物，因此应开展关注这些化合物在组织甚至细胞水平代谢的研究，以阐明它们在脊柱裂发病机制和未来预防中的作用。
