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采用磁共振成像评估早产儿双胎的垂体高度:生长和性别的影响。

Pituitary gland height evaluated with magnetic resonance imaging in premature twins: the impact of growth and sex.

机构信息

Department of Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, P.O. Box 1186, 45110, Ioannina, Greece.

Department of Medical Physics, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.

出版信息

Pediatr Radiol. 2024 May;54(5):787-794. doi: 10.1007/s00247-024-05873-0. Epub 2024 Feb 22.

Abstract

BACKGROUND

Pituitary gland height reflects secretory activity of the hypothalamo-pituitary axis.

OBJECTIVE

To assess the cumulative impact of fetal growth and sex on pituitary gland height in premature twins, dissociated from prematurity.

MATERIALS AND METHODS

A retrospective study was conducted, assessing the pituitary gland height in 63 pairs of preterm twins, measured from T1-weighted magnetic resonance imaging (MRI). Auxological parameters, including body weight, body length, and head circumference, at birth and at the time of MRI, were used as proxies for fetal and postnatal growth, respectively. The study population was divided into two groups, using corrected age at around term equivalent as the cutoff point. Statistical analysis was performed using mixed-effects linear regression models.

RESULTS

When pituitary gland height was evaluated at around term equivalent, a greater pituitary gland height, suggesting a more immature hypothamo-pituitary axis, was associated with the twin exhibiting lower auxological data at birth. The same association was observed when body weight and length at MRI were used as covariants. In the group evaluated after term equivalent, a smaller pituitary gland height, suggesting a more mature hypothamo-pituitary axis, was associated with male sex. This difference was observed in twin pairs with higher average body weight at birth, and in babies exhibiting higher auxological data at MRI.

CONCLUSION

After isolating the effect of prematurity, at around term equivalent, pituitary gland height reflects the cumulative impact of fetal growth on the hypothalamo-pituitary axis. Subsequently, pituitary gland height shows effects of sex and of fetal and postnatal growth.

摘要

背景

脑垂体高度反映了下丘脑-垂体轴的分泌活动。

目的

评估胎儿生长和性别对早产双胞胎脑垂体高度的累积影响,这些双胞胎与早产无关。

材料和方法

进行了一项回顾性研究,评估了 63 对早产双胞胎的脑垂体高度,这些双胞胎的脑垂体高度是通过 T1 加权磁共振成像(MRI)测量的。出生时和进行 MRI 时的体格生长参数,包括体重、身长和头围,分别作为胎儿和出生后生长的替代指标。研究人群分为两组,以校正胎龄为界。使用混合效应线性回归模型进行统计分析。

结果

当评估接近足月时的脑垂体高度时,脑垂体高度较高,提示下丘脑-垂体轴更不成熟,与出生时双胞胎的体格生长数据较低有关。当使用 MRI 时的体重和身长作为协变量时,也观察到了同样的关联。在评估接近足月后,脑垂体高度较小,提示下丘脑-垂体轴更成熟,与男性性别有关。这种差异在出生时平均体重较高的双胞胎中观察到,并且在 MRI 时体格生长数据较高的婴儿中观察到。

结论

在排除早产影响后,接近足月时,脑垂体高度反映了胎儿生长对下丘脑-垂体轴的累积影响。随后,脑垂体高度显示出性别以及胎儿和出生后生长的影响。

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