足月健康小于胎龄新生儿血清载脂蛋白B、载脂蛋白A-1及其比值的评估

Agrawal A, Shrivastava J, Dwivedi R, Siddiqui M

J Neonatal Perinatal Med. 2017;10(1):49-53. doi: 10.3233/NPM-1672.

BACKGROUND

Programmed changes in growth restricted fetuses can increase the risk of adulthood diseases due to elevated serum cholesterol and apolipoprotein-B (Apo-B) concentrations. Increasing evidence demonstrated the role of apoB/apoA-I ratio as a strong risk factor for cardiovascular diseases.

OBJECTIVE

To determine the concentration of cord blood lipoproteins and apolipoproteins as well as their correlation with birth weight.

METHODS

This cross-sectional study was conducted in a teaching institution in central India. Healthy full-term newborns, born out of normal vaginal deliveries, were recruited. Cases include term small for gestational age (SGA) babies while term appropriate for gestational age (AGA) babies were taken as controls. Their umbilical venous blood was collected and sent for biochemical analysis.

RESULTS

Out of 126 healthy newborns, 66 were cases and 60 were controls. Mean values of serum triglyceride (141.56±69.67 mg/dl vs. 113.67±33.38 mg/dl; p < 0.006; 95% CI = 8.31 to 47.46) and serum apo-B/apo-A-1 ratio (0.67±0.28 vs. 0.55±0.20; p < 0.007; 95% CI = 0.033 to 0.206) were significantly high and that of serum high density cholesterol (35.84±10.42 mg/dl vs. 40.73±11.70 mg/dl; p < 0.014; 95% CI = -8.79 to -0.98) and Apo-A1 [87.59±12.44 mg/dl vs. 101.87±35.07 mg/dl; p = 0.002; 95% CI = -23.39 to -5.16) were significantly low in SGA newborns. Serum cholesterol, very low-density cholesterol rlow-density cholesterol rand Apo-B did not show any significant difference. Among SGA newborns significant negative correlation was seen between birth weight and apo-B/apo-A1 and serum triglyceride, while birth weight and serum apo-A1 level showed significant positive correlation. There was no statistically significant correlation between birth weight and other parameters.

CONCLUSION

These findings further support the association of prenatal factors with lipid profile rand can serve as starting point for studying lipid transport system changes during early life in Indian population.

背景

生长受限胎儿的程序性变化会因血清胆固醇和载脂蛋白B（Apo-B）浓度升高而增加成年疾病的风险。越来越多的证据表明，载脂蛋白B/载脂蛋白A-I比值是心血管疾病的一个重要危险因素。

目的

测定脐血脂蛋白和载脂蛋白的浓度及其与出生体重的相关性。

方法

这项横断面研究在印度中部的一家教学机构进行。招募了经正常阴道分娩的健康足月新生儿。病例包括足月小于胎龄（SGA）婴儿，而足月适于胎龄（AGA）婴儿作为对照。采集他们的脐静脉血并送去进行生化分析。

结果

在126名健康新生儿中，66例为病例，60例为对照。SGA新生儿的血清甘油三酯（141.56±69.67mg/dl对113.67±33.38mg/dl；p<0.006；95%CI=8.31至47.46）和血清载脂蛋白B/载脂蛋白A-1比值（0.67±0.28对0.55±0.20；p<0.007；95%CI=0.033至0.206）显著升高，而血清高密度胆固醇（35.84±10.42mg/dl对40.73±11.70mg/dl；p<0.014；95%CI=-8.79至-0.98）和载脂蛋白A1[87.59±12.44mg/dl对101.87±35.07mg/dl；p=0.002；95%CI=-23.39至-5.16）显著降低。血清胆固醇、极低密度胆固醇、低密度胆固醇和载脂蛋白B没有显示出任何显著差异。在SGA新生儿中，出生体重与载脂蛋白B/载脂蛋白A1和血清甘油三酯之间存在显著负相关，而出生体重与血清载脂蛋白A1水平呈显著正相关。出生体重与其他参数之间没有统计学上的显著相关性。