Department of Pediatrics, University of Padua, Padua, Italy.
Kidney Int. 2011 Jul;80(1):119-23. doi: 10.1038/ki.2011.99. Epub 2011 Apr 13.
Low birth weight, caused either by preterm birth or by intrauterine growth restriction, has recently been associated with increased rates of adult renal and cardiovascular disease. Since aortic intima-media thickening is a noninvasive marker of preclinical vascular disease, we compared abdominal aortic intima-media thickness among intrauterine growth restricted and equivalent gestational age fetuses in utero and at 18 months of age. The relationship between intrauterine growth restriction, fetal aortic thickening, and glomerular function during infancy was measured by enrolling 44 mothers with single-fetus pregnancies at 32 weeks gestation: 23 growth restricted and 21 of appropriate gestational age as controls. Abdominal aortic intima-media thickness was measured by ultrasound at enrollment and again at 18 months of age. Fetuses with intrauterine growth restriction had significantly higher abdominal aortic intima-media thickness compared with age controls when measured both in utero and at 18 months. At 18 months, the median urinary microalbumin and median albumin-creatinine ratio were significantly higher in those infants who experienced intrauterine growth restriction compared to the controls. Our results show that intrauterine growth restriction is associated with persistent aortic wall thickening and significantly higher microalbuminuria during infancy.
低出生体重,无论是由早产还是宫内生长受限引起的,最近都与成人肾脏和心血管疾病的发生率增加有关。由于主动脉内膜中层增厚是临床前血管疾病的无创标志物,我们比较了宫内生长受限和相当胎龄胎儿的腹主动脉内膜中层厚度在宫内和 18 个月时。通过招募 44 名妊娠 32 周的单胎孕妇,测量了宫内生长受限、胎儿主动脉增厚和婴儿期肾小球功能之间的关系:23 名生长受限和 21 名胎龄适当作为对照组。通过超声在入组时和 18 个月时测量腹主动脉内膜中层厚度。与年龄对照组相比,宫内生长受限的胎儿在宫内和 18 个月时的腹主动脉内膜中层厚度明显更高。18 个月时,与对照组相比,经历宫内生长受限的婴儿的尿微量白蛋白和白蛋白-肌酐比值中位数明显更高。我们的结果表明,宫内生长受限与持续性主动脉壁增厚和婴儿期微量白蛋白尿显著增加有关。