Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Neonatal Intensive Care Unit, "Alexandra" University and State Maternity Hospital, Athens, Greece.
J Matern Fetal Neonatal Med. 2021 Jul;34(13):2166-2172. doi: 10.1080/14767058.2019.1659774. Epub 2019 Sep 8.
Lipocalin-2 (LCN-2) has been identified as an osteoblast-secreted hormone regulating immunity, inflammation and metabolic homeostasis and has emerged as a diagnostic and prognostic biomarker for acute kidney injury in neonates. We investigated the impact of fetal growth on antepartum maternal serum, cord serum and breast milk LCN-2 concentrations and the associations of the latter with perinatal parameters.
Maternal serum, cord serum and breast milk LCN-2 concentrations were measured by ELISA in samples from 80 mothers who delivered 40 appropriate (AGA), 20 large for gestational age (LGA) and 20 intrauterine growth restricted (IUGR) neonates, classified by customized weight centiles. LCN-2 concentrations were associated with birth weight, customized centile, gender, maternal age and delivery mode.
Antepartum maternal serum LCN-2 concentrations were significantly higher in women delivering AGA infants compared to the other two groups. Cord blood LCN-2 concentrations were significantly higher compared to maternal ones; furthermore, they were significantly elevated in the IUGR group compared to the LGA one ( = .019). Lowest concentrations were detected in breast milk, which did not differ between the three growth groups. A negative correlation was documented between cord blood LCN-2 concentrations and customized centiles (: -0.304, = .007).
The higher cord serum LCN-2 concentrations, compared to maternal ones, may point to its fetal origin and potential role in intrauterine growth. The negative correlation of cord LCN-2 concentrations with customized centiles, possibly implies reduced nephron endowment/subclinical kidney damage in IUGR neonates. The extremely low LCN-2 breast milk concentrations could imply that the secretion of LCN-2 from maternal circulation to breast milk is not influenced by factors leading to intrauterine growth pathology.
脂联素-2（LCN-2）已被确定为一种成骨细胞分泌的激素，可调节免疫、炎症和代谢稳态，并已成为新生儿急性肾损伤的诊断和预后生物标志物。我们研究了胎儿生长对产前母血清、脐血清和母乳 LCN-2 浓度的影响，以及后者与围产儿参数的关系。
采用 ELISA 法检测 80 名产妇的母血清、脐血清和母乳 LCN-2 浓度，这些产妇分娩的新生儿分别为 40 名适宜（AGA）、20 名巨大儿（LGA）和 20 名宫内生长受限（IUGR），根据定制体重百分位进行分类。LCN-2 浓度与出生体重、定制百分位、性别、产妇年龄和分娩方式相关。
与后两组相比，分娩 AGA 婴儿的产妇产前母血清 LCN-2 浓度显著升高。脐血 LCN-2 浓度明显高于母血；此外，与 LGA 组相比，IUGR 组的 LCN-2 浓度明显升高（=0.019）。母乳中的浓度最低，三组之间无差异。还发现脐血 LCN-2 浓度与定制百分位呈负相关（r=-0.304，=0.007）。
与母血相比，脐血 LCN-2 浓度升高可能表明其来源于胎儿，并可能在宫内生长中发挥作用。脐血 LCN-2 浓度与定制百分位呈负相关，可能意味着 IUGR 新生儿的肾单位数量减少/亚临床肾损伤。母乳中极低的 LCN-2 浓度可能意味着 LCN-2 从母体循环分泌到母乳中不受导致宫内生长病理的因素影响。
