Hansen-Pupp Ingrid, Hellgren Gunnel, Hård Anna-Lena, Smith Lois, Hellström Ann, Löfqvist Chatarina
Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
J Clin Endocrinol Metab. 2015 Jun;100(6):2380-7. doi: 10.1210/jc.2015-1081. Epub 2015 Mar 31.
Adiponectin enhances insulin sensitivity and may play a role in fetal and postnatal growth.
This study aimed to determine whether early postnatal adiponectin concentration change is related to postnatal growth in very preterm infants.
SETTING, DESIGN, AND PATIENTS: This was an in-hospital, prospective, longitudinal cohort study of 52 preterm infants with a gestational age (GA) of 26.0 ± 1.9 (SD) weeks and birth weight (BW) of 889 ± 284 g.
An analysis of adiponectin was performed on cord blood at birth and peripheral blood at 72 hours, day 7, and then weekly until postmenstrual age (PMA) 40 weeks. Weight, length, and head circumference (HC) measurement was performed weekly and SD scores (SDS) calculated. Energy and protein intake was calculated daily from birth until PMA 35 weeks.
Mean adiponectin concentration increased from 6.8 ± 4.4 μg/mL at 72 hours to 37.4 ± 22.2 μg/mL at 3 weeks; during days 3-21, it was 21.4 ± 12 μg/mL and correlated with GA at birth (r = 0.46, P = .001; BW: r = 0.71, P < .001; BW(SDS): r = 0.42, P = .003). Furthermore, mean adiponectin during days 3-21 correlated with weight(SDS), length(SDS), and HC(SDS) (r = 0.62, 0.65, and 0.62, respectively; all P < .001) at PMA 35 wk). Energy intake (kcal/kg/d) correlated with mean adiponectin during days 3-21 (r = 0.35, P < .013).
In very preterm infants, adiponectin concentrations increased markedly in the first 3 weeks, and a greater increase was associated with improved postnatal growth.
脂联素可增强胰岛素敏感性，可能在胎儿期和出生后生长中发挥作用。
本研究旨在确定极早产儿出生后早期脂联素浓度变化是否与出生后生长有关。
地点、设计和患者：这是一项在医院内进行的前瞻性纵向队列研究，研究对象为52例孕周为26.0±1.9（标准差）周、出生体重为889±284 g的早产儿。
在出生时采集脐血，在出生后72小时、第7天，然后每周采集外周血，直至孕龄（PMA）40周，进行脂联素分析。每周测量体重、身长和头围（HC），并计算标准差评分（SDS）。从出生到孕龄35周，每天计算能量和蛋白质摄入量。
脂联素平均浓度从72小时时的6.8±4.4μg/mL增加到3周时的37.4±22.2μg/mL；在第3 - 21天，其浓度为21.4±12μg/mL，与出生时的孕周相关（r = 0.46，P = 0.001；出生体重：r = 0.71，P < 0.001；出生体重标准差评分：r = 0.42，P = 0.003）。此外，第3 - 21天的脂联素平均浓度与孕龄35周时的体重标准差评分、身长标准差评分和头围标准差评分相关（r分别为0.62、0.65和0.62；均P < 0.001）。能量摄入量（千卡/千克/天）与第3 - 21天的脂联素平均浓度相关（r = 0.35，P < 0.013）。
在极早产儿中，脂联素浓度在出生后的前3周显著增加，增加幅度越大，出生后生长改善越明显。
