Verhaeghe J, Van Bree R, Van Herck E, Laureys J, Bouillon R, Van Assche F A
Department of Obstetrics and Gynecology, Katholieke Universiteit Leuven, Belgium.
Am J Obstet Gynecol. 1993 Jul;169(1):89-97. doi: 10.1016/0002-9378(93)90137-8.
Our purpose was to determine the correlation between birth weight and hormones or growth factors believed to be involved in fetal growth: insulin, insulin-like growth factors I and II, and insulin-like growth factor binding protein-1.
Five hundred thirty-eight cord serum samples were analyzed for insulin-like growth factor-I, insulin-like growth factor-II, C-peptide, and insulin-like growth factor binding protein-1 by immunoassay. Samples included all gestational ages in the third trimester and a large range of birth weights.
Cord serum insulin-like growth factor-I concentrations increased until 39 weeks (+84% from 28 to 29 weeks), followed by a 21% decline at 41 weeks. Insulin-like growth factor-I levels were decreased by 40% in small-for-gestational-age (< 10th percentile) newborns and were increased by 28% in large-for-gestational-age (> 90th percentile) newborns in the absence of diabetes. Insulin-like growth factor-I levels were best correlated with birth weight (R = 0.48, p < 0.001). Cord serum insulin-like growth factor-II concentrations were sixfold to tenfold higher than those of insulin-like growth factor-I and were 8% to 10% (p < 0.001) higher in large-for-gestational-age than in average-weight and small-for-gestational-age newborns. Cord serum C-peptide concentrations were 28% and 34% higher in large-for-gestational-age than in average-for-gestational-age and small-for-gestational-age newborns, respectively. Insulin-like growth factor binding protein-1 levels were increased in preterm average-for-gestational-age and in term small-for-gestational-age newborns compared with term average-for-gestational-age newborns and showed a negative correlation with birth weight (R = -0.43, n = 131, p < 0.001). Insulin-like growth factor binding protein-1 was not correlated with C-peptide concentrations.
Insulin-like growth factors I and II and insulin are all related to fetal growth and weight gain, and insulin-like growth factor-I correlates best with birth weight. Insulin is mainly related to fetal overgrowth (macrosomia). Insulin-like growth factor binding protein-1 may be a growth inhibitor in the fetus.
我们的目的是确定出生体重与被认为参与胎儿生长的激素或生长因子之间的相关性，这些激素或生长因子包括胰岛素、胰岛素样生长因子I和II以及胰岛素样生长因子结合蛋白-1。
通过免疫测定法对538份脐血血清样本进行胰岛素样生长因子-I、胰岛素样生长因子-II、C肽和胰岛素样生长因子结合蛋白-1的分析。样本包括孕晚期的所有孕周以及广泛的出生体重范围。
脐血血清胰岛素样生长因子-I浓度在39周前持续升高（从28周到29周增加84%），随后在41周下降21%。在无糖尿病的情况下，小于胎龄儿（<第10百分位数）新生儿的胰岛素样生长因子-I水平降低40%，大于胎龄儿（>第90百分位数）新生儿的胰岛素样生长因子-I水平升高28%。胰岛素样生长因子-I水平与出生体重的相关性最佳（R = 0.48，p < 0.001）。脐血血清胰岛素样生长因子-II浓度比胰岛素样生长因子-I高6至10倍，大于胎龄儿的胰岛素样生长因子-II浓度比平均体重和小于胎龄儿新生儿高8%至10%（p < 0.001）。脐血血清C肽浓度在大于胎龄儿中分别比适于胎龄儿和小于胎龄儿新生儿高28%和34%。与足月适于胎龄儿新生儿相比，早产适于胎龄儿和足月小于胎龄儿新生儿的胰岛素样生长因子结合蛋白-1水平升高，且与出生体重呈负相关（R = -0.43，n = 131，p < 0.001）。胰岛素样生长因子结合蛋白-1与C肽浓度无相关性。
胰岛素样生长因子I和II以及胰岛素均与胎儿生长和体重增加有关，且胰岛素样生长因子-I与出生体重的相关性最佳。胰岛素主要与胎儿过度生长（巨大儿）有关。胰岛素样生长因子结合蛋白-1可能是胎儿生长的抑制剂。
