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新生儿宫内生长、胰岛素样生长因子I(IGF-I)、IGF结合蛋白-3与骨矿物质状态之间的关系。

The relationship among intrauterine growth, insulinlike growth factor I (IGF-I), IGF-binding protein-3, and bone mineral status in newborn infants.

作者信息

Akcakus Mustafa, Koklu Esad, Kurtoglu Selim, Kula Mustafa, Koklu Selmin Suner

机构信息

Department of Pediatrics, Division of Neonatology, Erciyes University, School of Medicine, Kayser, Turkey.

出版信息

Am J Perinatol. 2006 Nov;23(8):473-80. doi: 10.1055/s-2006-954822. Epub 2006 Nov 8.

Abstract

Insulinlike growth factors (IGFs) exert profound effects on somatic growth and cellular proliferation of many tissues and play an essential role in bone metabolism. The aim of this study was to investigate how fetal growth and bone mineralization correlate with IGF-I and IGF-binding protein-3 (IGFBP-3) levels of newborn infants and their mothers. In addition, we aimed to determine the predictive value of anthropometric measurements on variability in bone mineral status. Umbilical cord venous blood samples were obtained at delivery from 100 term newborn infants. Forty of the newborn infants had birthweights appropriate for gestational age (AGA), 30 were small for gestational age (SGA), and 30 were large for gestational age (LGA). Data were acquired using whole-body dual-energy X-ray absorptiometry scanner with a pediatric platform. Umbilical cord serum IGF-I concentrations were higher in LGA newborns ( P < 0.01), but lower in SGA newborns ( P < 0.01) than in AGA newborns. Umbilical cord serum IGFBP-3 concentrations in LGA newborns were significantly greater than in SGA and AGA newborns ( P < 0.01 and P < 0.01, respectively). Whole-body bone mineral density (WB BMD) was higher in LGA babies (0.442 +/- 0.025 g/cm2 [SD]; P < 0.01) but lower in SGA (0.381 +/- 0.027 g/cm 2; P < 0.0001) than in AGA babies (0.426 +/- 0.022 g/cm2). WB BMD and content (WB BMC) were correlated significantly with birthweight, birth height, head circumference, body mass index (BMI) of the infants; ponderal index and triceps skinfold thickness (reflecting fat stores) of the infants; cord serum IGF-I concentration, serum IGF-I concentration of the mothers; and fat mass, proportionate fat mass, weight, and BMI of the mothers. In contrast, WB BMC was also correlated positively with cord serum IGFBP-3 concentration and gestational age, and WB BMD was positively correlated with serum IGFBP-3 levels of the mothers. Umbilical cord serum IGF-I concentration of the infants was correlated significantly with the concentration of the mothers ( R = 0.232; P = 0.020). Umbilical cord serum IGF-I and IGFBP-3 concentrations were correlated significantly with the fat mass, gestational age, birthweight, birth height, head circumference, and BMI of the infants. Umbilical cord IGF-I concentration was also correlated with ponderal index and triceps skinfold thickness of the infants, maternal weight, BMI, and proportionate fat mass of the infants. Stepwise multiple regression analyses showed no significant relation between bone indices (WB BMD, WB BMC) and the infant's or mother's variations including serum IGF-I and IGFBP-3 concentrations. Birthweight and gestational age are related to bone indices. However, the present study does not provide support for the hypothesis that serum IGF-I and IGFBP-3 levels of infants and their mothers may play a major role in the regulation of bone metabolism in the developing skeleton.

摘要

胰岛素样生长因子(IGFs)对许多组织的体细胞生长和细胞增殖具有深远影响,在骨代谢中发挥着重要作用。本研究的目的是探讨胎儿生长和骨矿化与新生儿及其母亲的IGF-I和胰岛素样生长因子结合蛋白-3(IGFBP-3)水平之间的相关性。此外,我们旨在确定人体测量指标对骨矿物质状态变异性的预测价值。在分娩时从100名足月儿获取脐静脉血样本。其中40名新生儿出生体重适于胎龄(AGA),30名小于胎龄(SGA),30名大于胎龄(LGA)。使用带有儿科平台的全身双能X线吸收仪获取数据。LGA新生儿的脐血血清IGF-I浓度高于AGA新生儿(P<0.01),而SGA新生儿的脐血血清IGF-I浓度低于AGA新生儿(P<0.01)。LGA新生儿的脐血血清IGFBP-3浓度显著高于SGA和AGA新生儿(分别为P<0.01和P<0.01)。LGA婴儿的全身骨密度(WB BMD)较高(0.442±0.025 g/cm²[标准差];P<0.01),而SGA婴儿的WB BMD较低(0.381±0.027 g/cm²;P<0.0001),AGA婴儿的WB BMD为0.426±0.022 g/cm²。WB BMD和骨含量(WB BMC)与婴儿的出生体重、出生身高、头围、体重指数(BMI)显著相关;与婴儿的 ponderal指数和肱三头肌皮褶厚度(反映脂肪储备)显著相关;与脐血血清IGF-I浓度、母亲的血清IGF-I浓度显著相关;与母亲的脂肪量、脂肪比例、体重和BMI显著相关。相比之下,WB BMC还与脐血血清IGFBP-3浓度和胎龄呈正相关,WB BMD与母亲的血清IGFBP-3水平呈正相关。婴儿的脐血血清IGF-I浓度与母亲的浓度显著相关(R=0.232;P=0.020)。脐血血清IGF-I和IGFBP-3浓度与婴儿的脂肪量、胎龄、出生体重、出生身高、头围和BMI显著相关。脐血IGF-I浓度还与婴儿的ponderal指数和肱三头肌皮褶厚度、母亲的体重、BMI以及婴儿的脂肪比例相关。逐步多元回归分析显示,骨指标(WB BMD、WB BMC)与婴儿或母亲的各项变量(包括血清IGF-I和IGFBP-3浓度)之间无显著关系。出生体重和胎龄与骨指标相关。然而,本研究并不支持婴儿及其母亲的血清IGF-I和IGFBP-3水平可能在发育中骨骼的骨代谢调节中起主要作用这一假说。

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