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脐带血脂谱及相关因素:一项出生队列研究的基线数据

Cord blood lipid profile and associated factors: baseline data of a birth cohort study.

作者信息

Kelishadi Roya, Badiee Zohreh, Adeli Khosrow

机构信息

Preventive Paediatric Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Iran.

出版信息

Paediatr Perinat Epidemiol. 2007 Nov;21(6):518-24. doi: 10.1111/j.1365-3016.2007.00870.x.

Abstract

The cord blood lipid profile may be associated with lifelong changes in the metabolic functions of the individual. The aim of the present study was for the first time in Iran to assess the cord blood lipid profile of neonates, as well as some of its environmental influencing factors. The subjects were 442 (218 boys and 224 girls) normal vaginal delivery newborns. Overall, 14.4% of neonates were preterm and the rest were full-term. In total, 9.2% (n = 35) of the full-term newborns were small-for-gestational-age (SGA), of which 16 had a ponderal index (PI) below the 10th percentile (SGA I) and 19 had a PI above the 10th percentile (SGA II), 5.5% (n = 21) were large-for-gestational-age (LGA), and the remainder were appropriate-for-gestational-age (AGA).Before becoming pregnant, 6.9% of mothers were underweight, 49.3% had normal body mass index (BMI), 39.4% were overweight and 4.4% were obese. Total and high-density lipoprotein cholesterol (HDL-C) in girls were significantly higher than in boys (80.3 +/- 33.3 and 31.1 +/- 9.9 vs. 73.3 +/- 23.1 and 28.8 +/- 8.7 mg/dL, respectively, P < 0.05). The mean apolipoprotein A (apoA) of neonates with underweight mothers was significantly lower, and the mean apoB level of those with overweight mothers was significantly higher than other neonates. The mean low-density lipoprotein cholesterol (LDL-C), HDL-C and apoA of the LGA newborns were significantly lower, and their apoB was significantly higher compared with AGA and SGA neonates. The SGA I neonates had significantly lower total cholesterol, LDL-C, HDL-C and apoA, as well as higher triglycerides, lipoprotein a and apoB than the SGA II group. The mean cord blood triglycerides of full-term neonates was significantly higher than preterm neonates (69.4 +/- 11.9 vs. 61.4 +/- 12.7 mg/dL, respectively, P = 0.04). A preconception maternal BMI of > or =25 kg/m(2) correlated significantly with the cord triglycerides (OR = 1.3, [95% CI 1.07, 1.5]) and with apoB (OR = 1.4, [95% CI 1.1, 1.5]). The BMI <18 of mothers before pregnancy correlated with low HDL-C (OR = 1.3, [95% CI 1.04, 1.7]). Birthweight correlated with high cord triglyceride level (SGA: OR = 1.4, [95% CI 1.1, 1.7]; LGA: OR = 1.6, [95% CI 1.3, 1.7] compared with AGA). These associations remained significant even after adjusting for the preconception BMI of mothers. Our findings reflect the possible interaction of environmental factors and fetal growth and the in utero lipid metabolism. Long-term longitudinal studies in different ethnicities would help to elucidate the relationship.

摘要

脐血脂谱可能与个体代谢功能的终身变化有关。本研究的目的是首次在伊朗评估新生儿的脐血脂谱及其一些环境影响因素。研究对象为442例(218名男婴和224名女婴)正常阴道分娩的新生儿。总体而言,14.4%的新生儿为早产儿,其余为足月儿。足月新生儿中,9.2%(n = 35)为小于胎龄儿(SGA),其中16例的体重指数(PI)低于第10百分位数(SGA I),19例的PI高于第10百分位数(SGA II),5.5%(n = 21)为大于胎龄儿(LGA),其余为适于胎龄儿(AGA)。怀孕前,6.9%的母亲体重过轻,49.3%的母亲体重指数(BMI)正常,39.4%的母亲超重,4.4%的母亲肥胖。女孩的总胆固醇和高密度脂蛋白胆固醇(HDL-C)显著高于男孩(分别为80.3±33.3和31.1±9.9 vs. 73.3±23.1和28.8±8.7 mg/dL,P < 0.05)。母亲体重过轻的新生儿的平均载脂蛋白A(apoA)显著较低,母亲超重的新生儿的平均载脂蛋白B水平显著高于其他新生儿。与AGA和SGA新生儿相比,LGA新生儿的平均低密度脂蛋白胆固醇(LDL-C)、HDL-C和apoA显著较低,其apoB显著较高。SGA I新生儿的总胆固醇、LDL-C、HDL-C和apoA显著低于SGA II组,甘油三酯、脂蛋白a和apoB则较高。足月新生儿的脐血甘油三酯平均水平显著高于早产儿(分别为69.4±11.9和61.4±12.7 mg/dL,P = 0.04)。怀孕前母亲BMI≥25 kg/m²与脐血甘油三酯(OR = 1.3,[95%CI 1.07, 1.5])和apoB(OR = 1.4,[95%CI 1.1, 1.5])显著相关。怀孕前母亲BMI<18与低HDL-C相关(OR = 1.3,[95%CI 1.04, 1.7])。出生体重与高脐血甘油三酯水平相关(SGA:OR = 1.4,[95%CI 1.1, 1.7];LGA:OR = 1.6,[95%CI 1.3, 1.7],与AGA相比)。即使在调整母亲怀孕前BMI后,这些关联仍然显著。我们的研究结果反映了环境因素与胎儿生长及宫内脂质代谢之间可能的相互作用。不同种族的长期纵向研究将有助于阐明这种关系。

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