Department of Obstetrics and Gynecology of the University Hospital of the RWTH Aachen, Germany.
J Perinat Med. 2012 Jan 6;40(3):287-96. doi: 10.1515/jpm.2011.135.
Small for gestational age neonates (SGA) could be subdivided into two groups according to the underlying causes leading to low birth weight. Intrauterine growth restriction (IUGR) is a pathologic condition with diminished growth velocity and fetal compromised well-being, while non-growth restricted SGA neonates are constitutionally (genetically determined) small. Antenatal sonographic measurements are used to differentiate these two subgroups. Maternal metabolic changes contribute to the pathogenesis of IUGR. A disturbed lipid metabolism and cholesterol supply might affect the fetus, with consequences for fetal programming of cardiovascular diseases. We evaluated fetal serum lipids and hypothesized a more atherogenic lipoprotein profile in IUGR fetuses.
Umbilical cord serum lipids and oxidative modified, low-density lipoprotein (oxLDL) concentrations were measured by colorimetric enzymatic measurements, or by ELISA. Values of IUGR (n=36) and constitutionally small for gestational age neonates (SGA, n=22) were compared with those of healthy, adequate for gestational age, born neonates (CN, n=97). SAS-statistic software was used and two-way ANOVA was adjusted for gestational age at delivery.
Fetal high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) concentrations were found to be lower in the IUGR compared to the CN and SGA groups (HDL-C: P<0.001, TC: P<0.01). Atherogenic indices, including the oxLDL/LDL-C ratio, were increased in the IUGR compared to the CN group (oxLDL/LDL-C ratio: P<0.001).
Our results support the hypothesis of a disturbed cholesterol supply in IUGR fetuses. Born SGA has been shown to be a risk factor for developing cardiovascular disease later in life. Since HDL-C has anti-inflammatory properties, a reduced HDL-C during fetal development, and an increase in atherogenic indices, might provide a link to this observation in IUGR fetuses.
根据导致低出生体重的潜在原因，小胎龄儿（SGA）可分为两组。宫内生长受限（IUGR）是一种生长速度减慢、胎儿健康受损的病理状态，而非生长受限的 SGA 新生儿则是先天（遗传决定）的小。产前超声测量用于区分这两个亚组。母体代谢变化有助于 IUGR 的发病机制。脂质代谢紊乱和胆固醇供应可能会影响胎儿，对胎儿心血管疾病的编程产生影响。我们评估了胎儿血清脂质，并假设 IUGR 胎儿中存在更具动脉粥样硬化倾向的脂蛋白谱。
通过比色酶测定法或 ELISA 测定脐带血清脂质和氧化修饰的低密度脂蛋白（oxLDL）浓度。将 IUGR（n=36）和胎龄与体重相称的小胎龄儿（SGA，n=22）的数值与健康、胎龄适宜的出生儿（CN，n=97）的数值进行比较。使用 SAS 统计软件，并对分娩时的胎龄进行双因素方差分析调整。
与 CN 和 SGA 组相比，IUGR 组胎儿高密度脂蛋白胆固醇（HDL-C）和总胆固醇（TC）浓度较低（HDL-C：P<0.001，TC：P<0.01）。与 CN 组相比，IUGR 组的致动脉粥样硬化指数（包括 oxLDL/LDL-C 比值）升高（oxLDL/LDL-C 比值：P<0.001）。
我们的结果支持 IUGR 胎儿胆固醇供应紊乱的假设。已证明出生时的 SGA 是以后发生心血管疾病的危险因素。由于 HDL-C 具有抗炎特性，因此胎儿发育期间 HDL-C 减少和致动脉粥样硬化指数增加可能为 IUGR 胎儿的这一观察结果提供了联系。
