Wiznitzer A, Reece E A, Homko C, Furman B, Mazor M, Levy J
Department of Obstetrics and Gynecology, Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel.
Am J Perinatol. 1998 Jan;15(1):23-8. doi: 10.1055/s-2007-993893.
The Objective of this paper is to determine the relation between fetal macrosomia in offspring of nondiabetic women, and the levels of insulin-like growth factors (IGF-I, IGF-II), insulin growth factor binding protein-3 (IGFBP-3) and insulin, in maternal and neonatal compartments. Serum samples were obtained from normal pregnant women (n = 60) and their neonates (n = 60) between 37-41 weeks' gestation (mean 39 +/- 9). Neonates were categorized as appropriate for gestational age (AGA; 10th-90th percentile; n = 20), and large for gestational age (LGA; >90th percentile; n = 40). Maternal and neonatal serum samples were analyzed for levels of IGF-I, IGF-II, IGFBP-3 and insulin, by specific radioimmunoassays (RIAs). Serum levels were correlated with birth weight. The mean birth weight of the AGA group was 3296 +/- 500 g versus 4201 +/- 300 g for the LGA group (p <0.0001). Cord blood IGF-I was statistically higher in LGA group than in the AGA infants, (139 +/- 67 ng/mL and 80 +/- 32 ng/mL, respectively; p <0.0001). There was no correlation between maternal IGF-I serum levels and birth weight (363 +/- 131 in the AGA vs. 308 +/- 158 in the LGA group). IGF-II in maternal and cord blood did not correlate with fetal weight. Cord blood IGFBP-3 was significantly higher in the LGA group (1.1 +/- 0.07 microg/mL) than in the AGA group (0.96 +/- 0.05 microg/mL; p < 0.05). Maternal insulin levels were similar between the two groups. Neonatal insulin levels were higher in the LGA group (18 +/- microU/mL) as compared to the AGA group (16 +/- microU/mL), however, this difference did not reach statistical significance. Fetal cord blood levels of IGF-I and IGFBP-3 are directly correlated with the birth weight of large for gestational age fetuses. These data suggest that the somatotropic axis plays a role in fetal growth. Additionally, insulin growth factor-1 appears to be an in utero growth promoter in the development of fetal macrosomia in infants of nondiabetic women.
本文的目的是确定非糖尿病女性后代的巨大儿与母体和新生儿体内胰岛素样生长因子（IGF-I、IGF-II）、胰岛素生长因子结合蛋白-3（IGFBP-3）和胰岛素水平之间的关系。在妊娠37 - 41周（平均39±9周）期间，从60名正常孕妇及其60名新生儿中采集血清样本。新生儿被分为适于胎龄儿（AGA；第10至90百分位数；n = 20）和大于胎龄儿（LGA；>第90百分位数；n = 40）。通过特异性放射免疫分析（RIA）检测母体和新生儿血清样本中IGF-I、IGF-II、IGFBP-3和胰岛素的水平。血清水平与出生体重相关。AGA组的平均出生体重为3296±500 g，而LGA组为4201±300 g（p <0.0001）。LGA组脐血IGF-I在统计学上高于AGA组婴儿（分别为139±67 ng/mL和80±32 ng/mL；p <0.0001）。母体IGF-I血清水平与出生体重之间无相关性（AGA组为363±131，LGA组为308±158）。母体和脐血中的IGF-II与胎儿体重无关。LGA组脐血IGFBP-3显著高于AGA组（1.1±0.07μg/mL对0.96±0.05μg/mL；p <0.05）。两组母体胰岛素水平相似。LGA组新生儿胰岛素水平高于AGA组（18±mU/mL对16±mU/mL），然而，这种差异未达到统计学显著性。胎儿脐血中IGF-I和IGFBP-3水平与大于胎龄儿的出生体重直接相关。这些数据表明生长激素轴在胎儿生长中起作用。此外，胰岛素生长因子-1似乎是导致非糖尿病女性婴儿巨大儿发育的宫内生长促进因子。
