Duncan Andrea F, Frankfurt Joshua A, Heyne Roy J, Rosenfeld Charles R
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Health Science Center, Houston, Texas.
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Pediatr Res. 2017 May;81(5):780-786. doi: 10.1038/pr.2017.11. Epub 2017 Jan 18.
Preterm, very-low-birth-weight (PT-VLBW) neonates are at-risk for metabolic syndrome later in life. At 1-3 y, they exhibit excessive weight-for-length z-scores (Wt-L) and elevated systolic blood pressures (SBP). Serum adipokines are biomarkers of adiposity, but expression in PT-VLBW infants is unclear. We examined the correlation between serum adipokine levels, anthropometric measures and SBP in PT-VLBW neonates at follow-up.
This was a cross-sectional cohort study of PT-VLBW infants at 1, 2, and 3 y of age (40/cohort). We measured SBP, abdominal circumference (AC) and anthropometrics; calculated age/gender-specific z-scores for Wt, L, Wt-L and subscapular skin fold (SS), and measured serum adipokines.
Serum leptin was unaffected by chronologic age and gender, but was positively correlated with weight, Wt-L, AC, and SS at 1 and 3 y (P < 0.01). Female infants at 1 and 3 y had a more significant relationship than males between serum leptin and SS (P < 0.001, R = 0.75 and P < 0.001, R = 0.70, respectively). Adiponectin levels were 16-20% lower at 3 vs. 1-2 y (P = 0.02, ANOVA) and negatively correlated with SBP.
Although serum leptin was unrelated to advancing age, gender, and SBP in PT-VLBW infants, levels correlated with measures of adiposity at 1 and 3 y, females > males, suggesting leptin resistance may occur in early infancy.
早产、极低出生体重（PT-VLBW）新生儿日后患代谢综合征的风险较高。在1至3岁时，他们的身长体重z评分（Wt-L）过高，收缩压（SBP）升高。血清脂肪因子是肥胖的生物标志物，但在PT-VLBW婴儿中的表达尚不清楚。我们在随访中研究了PT-VLBW新生儿血清脂肪因子水平、人体测量指标与SBP之间的相关性。
这是一项对1岁、2岁和3岁的PT-VLBW婴儿（每组40例）进行的横断面队列研究。我们测量了SBP、腹围（AC）和人体测量指标；计算了年龄/性别特异性的体重、身长、Wt-L和肩胛下皮褶厚度（SS）的z评分，并检测了血清脂肪因子。
血清瘦素不受年龄和性别的影响，但在1岁和3岁时与体重、Wt-L、AC和SS呈正相关（P < 0.01）。1岁和3岁的女婴血清瘦素与SS之间的关系比男婴更显著（分别为P < 0.001，R = 0.75和P < 0.001，R = 0.70）。与1-2岁相比，3岁时脂联素水平降低了16-20%（P = 0.02，方差分析），且与SBP呈负相关。
虽然在PT-VLBW婴儿中血清瘦素与年龄增长、性别和SBP无关，但在1岁和3岁时其水平与肥胖指标相关，女性>男性，提示早期婴儿期可能出现瘦素抵抗。
