Leger J, Noel M, Limal J M, Czernichow P
Pediatric Endocrinology and Diabetes Unit, Hôpital Robert Debré, Paris, France.
Pediatr Res. 1996 Jul;40(1):101-7. doi: 10.1203/00006450-199607000-00018.
The aim of this study was to describe serum GH, IGF-I, and IGF binding protein (BP) 3 levels at birth and during the first 2 y of life in intrauterine growth-retarded (IUGR) children and to correlate these hormonal values with auxologic parameters noted during this period to investigate their predictive value on the postnatal growth pattern. Three hundred and seventeen children were included at birth and studied for auxologic and biologic parameters at birth, 3 and 30 d, and 3, 6, 12, 18, and 24 mo of age. At birth, when analyzed according to gestational age, serum GH levels were increased (p = 0.0001) and serum IGF-I and IGFBP3 levels were decreased (p = 0.0001) in IUGR as compared with normal neonates. When two cohorts were established at birth as a function of the ponderal index (PI) (< or = or > 3rd percentile), serum IGF-I and IGFBP3 levels were found to be significantly reduced in the case of low PI. All parameters were within normal limits at 1 mo of age and remained normal thereafter. During the first 3 mo of life, a positive correlation was found between IGF-I increment and weight gain (r = 0.28, p = 0.002). None of the biologic parameters at birth were predictive either of later growth or of short stature at 2 y of age. In conclusion, low serum IGF-I and IGFBP3 levels at birth were related to fetal malnutrition and were not predictive parameters for later growth.
本研究的目的是描述宫内生长受限(IUGR)儿童出生时及出生后2年内的血清生长激素(GH)、胰岛素样生长因子-I(IGF-I)和胰岛素样生长因子结合蛋白(BP)3水平,并将这些激素值与该时期记录的体格学参数相关联,以研究它们对出生后生长模式的预测价值。317名儿童在出生时被纳入研究,并在出生时、出生后3天和30天以及3、6、12、18和24个月时对其体格学和生物学参数进行研究。出生时,根据胎龄分析,与正常新生儿相比,IUGR儿童的血清GH水平升高(p = 0.0001),血清IGF-I和IGFBP3水平降低(p = 0.0001)。当根据体重指数(PI)(<或=或>第3百分位数)在出生时建立两个队列时,发现低PI情况下血清IGF-I和IGFBP3水平显著降低。所有参数在1个月大时均在正常范围内,此后保持正常。在生命的前3个月,发现IGF-I增量与体重增加之间存在正相关(r = 0.28,p = 0.002)。出生时的任何生物学参数均不能预测后期生长或2岁时的身材矮小。总之,出生时血清IGF-I和IGFBP3水平低与胎儿营养不良有关,且不是后期生长的预测参数。