Patel Leena, Cavazzoni Elena, Whatmore Andrew J, Carney Sally, Wales Jeremy K, Clayton Peter E, Gibson Alan T
Academic Unit of Child Health, The University of Manchester, Manchester M9 7AA, UK.
Pediatr Res. 2007 Jan;61(1):99-104. doi: 10.1203/01.pdr.0000250036.34522.f1.
We determined the contributions of IGF-I, IGFBP-3 and leptin to growth in extremely premature infants over the first two years. Weight (Wt), crown-to heel length (CHL), plasma IGF-I, IGFBP-3 and leptin were measured in infants (gestation 24-33 wk) at birth (n = 54), expected date of delivery (EDD) and 6, 12 and 24 mo post-EDD (n = 29). Area under the curve (AUC) for hormone levels was calculated over 4 periods: birth-EDD, EDD-200 d, EDD-350 d and EDD-700 d. IGFBP-3, but not IGF-I or leptin, on day 1 correlated with birth Wt SD scores (SDS) (r = 0.46, p = 0.002) and CHL SDS (r = 0.41, p = 0.01). Wt SDS at EDD correlated with AUC IGF-I, IGFBP-3 and leptin (birth-EDD), but leptin was the best predictor in multiple regression (r = 0.65, p < 0.0001). Wt at EDD + 700 d correlated with AUC leptin (EDD-700 d) (r = 0.62, p = 0.002). CHL SDS at EDD correlated with AUC IGFBP-3 and leptin (birth-EDD), but IGFBP-3 was the best predictor (r = 0.55, p < 0.0001). CHL at EDD + 700 d correlated with AUC IGF-I and IGFBP-3 (EDD-700 d), but IGFBP-3 was the best predictor (r = 0.47, p = 0.01). Wt and CHL at birth were associated with IGFBP-3 levels in these infants. Wt at EDD and EDD + 700 d was predicted by concurrent leptin output while linear growth at EDD and EDD + 700 d was predicted by IGFBP-3 output.
我们确定了胰岛素样生长因子-I（IGF-I）、胰岛素样生长因子结合蛋白-3（IGFBP-3）和瘦素在极早早产儿出生后头两年生长中的作用。对出生时（胎龄24 - 33周，n = 54）、预产期（EDD）以及预产期后6、12和24个月（n = 29）的婴儿测量体重（Wt）、顶跟长度（CHL）、血浆IGF-I、IGFBP-3和瘦素。计算4个时间段内激素水平的曲线下面积（AUC）：出生至预产期、预产期至200天、预产期至350天和预产期至700天。出生第1天的IGFBP-3与出生体重标准差评分（SDS）相关（r = 0.46，p = 0.002），与顶跟长度SDS相关（r = 0.41，p = 0.01），而IGF-I和瘦素无此相关性。预产期时的体重SDS与AUC IGF-I、IGFBP-3和瘦素（出生至预产期）相关，但在多元回归中瘦素是最佳预测因子（r = 0.65，p < 0.0001）。预产期 + 700天时的体重与AUC瘦素（预产期至700天）相关（r = 0.62，p = 0.002）。预产期时的顶跟长度SDS与AUC IGFBP-3和瘦素（出生至预产期）相关，但IGFBP-3是最佳预测因子（r = 0.55，p < 0.0001）。预产期 + 700天时顶跟长度与AUC IGF-I和IGFBP-3（预产期至70天）相关，但IGFBP-3是最佳预测因子（r = 0.47，p = 0.01）。这些婴儿出生时的体重和顶跟长度与IGFBP-3水平相关。预产期及预产期 + 700天时的体重由同期瘦素输出量预测，而预产期及预产期 + 700天时的线性生长由IGFBP-3输出量预测。
