Erdinc Kemal, Sarici S Umit, Akgul E Ozgur, Agilli Mehmet, Ozcan Okan
Department of Pediatrics .
J Matern Fetal Neonatal Med. 2014 Jan;27(1):30-5. doi: 10.3109/14767058.2013.799655. Epub 2013 May 30.
Oxidative stress and inflammation are the basic molecular mechanisms in bilirubin neurotoxicity. We aimed to investigate the relationship between serum bilirubin and an antioxidant, anti-inflammatory and neuroprotective peptid, adrenomedullin (AM) levels.
The correlation between serum bilirubin and AM levels was investigated in a total of 87 newborns. Newborns were further divided into two groups according to the serum bilirubin levels. Group I (with significant hyperbilirubinemia) and Group II (without significant hyperbilirubinemia) were compared with respect to demographic, anthropometric and biochemical parameters including serum AM levels.
In the correlation analysis, a significant positive correlation was detected between serum indirect bilirubin and AM levels in 87 newborns (p < 0.001, r = 0.945). In demographic, anthropometric and biochemical comparison of the two study groups, serum indirect bilirubin levels were 21.53 ± 3.59 and 9.37 ± 4.87 mg/dl in Groups I and II, respectively (p < 0.001), and serum AM levels were 1.45 ± 0.06 and 1.28 ± 0.07 ng/ml in Groups I and II, respectively (p < 0.001) CONCLUSION: AM probably plays a significant role in adverse effects and neuronal injury steps of significant hyperbilirubinemia. In parallel with the results of this study the role, effects and physiopathological basis of AM in neonatal hyperbilirubinemia should be established especially with further animal studies. Results of this study may be used in establishing reference values for AM as there are very limited number of studies in newborns.
氧化应激和炎症是胆红素神经毒性的基本分子机制。我们旨在研究血清胆红素与一种具有抗氧化、抗炎和神经保护作用的肽——肾上腺髓质素（AM）水平之间的关系。
共对87例新生儿的血清胆红素与AM水平之间的相关性进行了研究。根据血清胆红素水平将新生儿进一步分为两组。比较了I组（显著高胆红素血症组）和II组（无显著高胆红素血症组）在人口统计学、人体测量学和生化参数（包括血清AM水平）方面的差异。
在相关性分析中，87例新生儿的血清间接胆红素与AM水平之间存在显著正相关（p < 0.001，r = 0.945）。在两个研究组的人口统计学、人体测量学和生化比较中，I组和II组的血清间接胆红素水平分别为21.53 ± 3.59和9.37 ± 4.87mg/dl（p < 0.001），I组和II组的血清AM水平分别为1.45 ± 0.06和1.28 ± 0.07ng/ml（p < 0.001）。结论：AM可能在显著高胆红素血症的不良反应和神经元损伤过程中起重要作用。鉴于本研究结果，尤其需要通过进一步的动物研究来明确AM在新生儿高胆红素血症中的作用、影响和生理病理基础。由于针对新生儿的相关研究数量非常有限，本研究结果可用于建立AM的参考值。
