Leger J, Oury J F, Noel M, Baron S, Benali K, Blot P, Czernichow P
Pediatric Endocrinology and Diabetes Unit, Hôpital Robert Debré, Paris, France.
Pediatr Res. 1996 Jul;40(1):94-100. doi: 10.1203/00006450-199607000-00017.
The aim of this study was to relate human fetal growth retardation to specific hormone alterations. Serum levels of GH, IGF-I, IGF-II, and IGF binding protein (BP) 3 were measured during the second half of gestation after cordocentesis in 230 fetuses who were classified into normally grown (n = 166) and growth-retarded (n = 64) groups according to ante- and neonatal measurements. The normally grown group showed a progressive decline in serum GH levels toward term (r = -0.42, p = 0.0001), whereas serum IGF-I was increased (r = 0.55, p = 0.0001), as were serum IGF-II (r = 0.21, p = 0.008) and IGFBP3 levels (r = 0.19, p = 0.02), although less markedly. For all hormone levels, wide individual differences were found at any given age of gestation. The incidental presence of fetal malformations in either the normally grown group (n = 107 cases) or the growth-retarded group (n = 50 cases) had no apparent effect on these hormone levels as compared with members of the groups showing no fetal malformations (n = 73 cases). Comparison of the normally grown group with the growth-retarded group showed that serum IGF-I levels were significantly lower in the growth-retarded group (p = 0.001). No differences were found between the groups in serum GH, IGF-II, and IGFBP3 levels, although if data for the third trimester were taken alone, serum IGF-II levels were found to be lower in the growth-retarded group (p = 0.05). In conclusion, during the second half of gestation, fetal serum IGF-I levels may be influenced by nutritional factors controlling fetal growth. However, the wide individual differences in measurements make it a very poor biologic marker of intrauterine growth retardation.
本研究的目的是将人类胎儿生长迟缓与特定激素变化联系起来。在妊娠中期经脐静脉穿刺后，对230例胎儿测定了血清生长激素（GH）、胰岛素样生长因子-I（IGF-I）、胰岛素样生长因子-II（IGF-II）和胰岛素样生长因子结合蛋白（BP）3水平。根据产前和新生儿测量结果，将这些胎儿分为正常生长组（n = 166）和生长迟缓组（n = 64）。正常生长组血清GH水平在足月时呈逐渐下降趋势（r = -0.42，p = 0.0001），而血清IGF-I水平升高（r = 0.55，p = 0.0001），血清IGF-II（r = 0.21，p = 0.008）和IGFBP3水平也升高（r = 0.19，p = 0.02），尽管升高幅度较小。在任何给定的妊娠年龄，所有激素水平都存在很大的个体差异。正常生长组（n = 107例）或生长迟缓组（n = 50例）中偶然出现的胎儿畸形与未出现胎儿畸形的组（n = 73例）相比，对这些激素水平没有明显影响。正常生长组与生长迟缓组的比较显示，生长迟缓组血清IGF-I水平显著较低（p = 0.001）。两组血清GH、IGF-II和IGFBP3水平没有差异，尽管仅采用孕晚期数据时，发现生长迟缓组血清IGF-II水平较低（p = 0.05）。总之，在妊娠中期，胎儿血清IGF-I水平可能受控制胎儿生长的营养因素影响。然而测量结果中存在的广泛个体差异使其成为宫内生长迟缓非常差的生物学标志物。
