血清胰岛素样生长因子-1水平降低对小于胎龄儿中心动脉顺应性的影响

Impact of Decreased Serum Insulin-Like Growth Factor-1 Levels on Central Aortic Compliance in Small-for-Gestational-Age Infants.

作者信息

Akazawa Yohei, Kamiya Motoko, Yamazaki Shoko, Kawasaki Yoichiro, Nakamura Chizuko, Takeuchi Yusuke, Hachiya Akira, Kusakari Mai, Miyosawa Yukihide, Motoki Noriko, Koike Kenichi, Nakamura Tomohiko

机构信息

Department of Paediatrics, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

Neonatology. 2017;111(1):30-36. doi: 10.1159/000447480. Epub 2016 Aug 11.

DOI:10.1159/000447480

PMID:27508295

Abstract

BACKGROUND

Intrauterine growth restriction is associated with arterial hypertension in adulthood; however, the underlying mechanism is unclear.

OBJECTIVES

We hypothesized that serum insulin-like growth factor-1 (IGF-1) levels affect central aortic elastic properties and structure in small-for-gestational-age (SGA) infants.

METHODS

Eighteen SGA infants and 22 appropriate-for-gestational-age (AGA) infants were enrolled in this study. The serum IGF-1 level within 1 h of birth and abdominal aortic echo parameters at 1 week of age were retrospectively compared.

RESULTS

In the SGA infants, IGF-1 levels (27.6 ± 17.7 vs. 42.6 ± 15 ng/ml, p = 0.006), aortic strain (10.2 ± 3.1 vs. 12.8 ± 3.1%, p = 0.01), and aortic distensibility (0.73 ± 0.19 vs. 0.92 ± 0.34 cm2/dyn × 10-4, p = 0.05) were significantly lower compared with AGA infants. By contrast, blood pressure, aortic intima-media thickness (aIMT) in relation to body weight (383 ± 163 vs. 256 ± 43 μm/kg, p < 0.001), aortic stiffness index in relation to body weight (2.0 ± 1.7 vs. 1.1 ± 0.4, p = 0.005), and arterial pressure-strain elastic modulus (293 ± 72 vs. 242 ± 78 mm Hg, p = 0.04) were higher compared with AGA infants. In the SGA infants, IGF-1 levels were significantly correlated with aortic strain (r = 0.49, p = 0.04), aIMT in relation to body weight (r = -0.61, p = 0.007), and aortic stiffness index in relation to body weight (r = -0.63, p = 0.005).

CONCLUSIONS

Decreased serum IGF-1 levels in SGA infants may affect the vascular compliance and structure of the central aorta.

摘要

背景

宫内生长受限与成年期动脉高血压相关；然而，其潜在机制尚不清楚。

目的

我们假设血清胰岛素样生长因子-1（IGF-1）水平会影响小于胎龄（SGA）婴儿的中心主动脉弹性特性和结构。

方法

本研究纳入了18例SGA婴儿和22例适于胎龄（AGA）婴儿。回顾性比较出生后1小时内的血清IGF-1水平和1周龄时的腹主动脉回声参数。

结果

与AGA婴儿相比，SGA婴儿的IGF-1水平（27.6±17.7 vs. 42.6±15 ng/ml，p = 0.006）、主动脉应变（10.2±3.1 vs. 12.8±3.1%，p = 0.01）和主动脉扩张性（0.73±0.19 vs. 0.92±0.34 cm2/dyn×10-4，p = 0.05）显著降低。相比之下，SGA婴儿的血压、与体重相关的主动脉内膜中层厚度（aIMT）（383±163 vs. 256±43μm/kg，p < 0.001）、与体重相关的主动脉硬度指数（2.0±1.7 vs. 1.1±0.4，p = 0.005）和动脉压力-应变弹性模量（293±72 vs. 242±78 mmHg，p = 0.04）高于AGA婴儿。在SGA婴儿中，IGF-1水平与主动脉应变（r = 0.49，p = 0.04）、与体重相关的aIMT（r = -0.61，p = 0.007）和与体重相关的主动脉硬度指数（r = -0.63，p = 0.005）显著相关。