Fetal plasma leptin concentrations: Relationship with different intrauterine growth patterns from 19 weeks to term
Fetal plasma leptin concentrations: Relationship with different intrauterine growth patterns from 19 weeks to term
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DOI：
10.1203/00006450-200011000-00016
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发表时间：
2000-11-01
影响因子：
3.6
通讯作者：
Beck-Peccoz, P
中科院分区：
文献类型：
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作者：
Cetin, I;Morpurgo, PS;Beck-Peccoz, P
研究了40例正常（适合胎龄）胎儿、25例宫内生长受限（IUGR）胎儿和18例妊娠期糖尿病母亲（GDM）胎儿在19 - 41周的子宫内胎儿生长与胎儿瘦素浓度之间的关系，代表了不同的宫内生长模式。脐静脉血浆瘦素浓度在子宫内胎儿采血或分娩时测定。早在妊娠19周就可测量血浆瘦素。脐静脉血清瘦素浓度与动脉血清瘦素浓度差异有统计学意义（0.6 +/- 0.6 ng/mL, p < 0.01）。在AGA和IUGR胎儿中，胎儿瘦素浓度与胎龄（p < 0.001）和体重（p < 0.001）呈显著正相关。妊娠34周后，AGA组瘦素浓度显著高于IUGR组（p < 0.05），而每公斤胎重瘦素（Leptin /kg）含量差异不显著。脐动脉多普勒速度和胎儿心率异常组瘦素/kg显著高于生物物理生化指标正常组（p < 0.05）。GDM胎儿的循环血浆瘦素和瘦素/kg均显著高于正常胎儿（p < 0.001），且与超声测量的腹部脂肪量相关。在任何一组胎儿中均未观察到性别差异。这些发现表明胎儿瘦素浓度和胎儿脂肪量之间有明确的关系。严重IUGR的数据表明，瘦素浓度升高与子宫内胎儿窘迫的迹象有关。
The relationship between in utero fetal growth and fetal leptin concentrations was investigated between 19 and 41 wk in 40 normal (appropriate for gestational age, AGA) fetuses, in 25 intrauterine growth-restricted (IUGR) fetuses, and in 18 fetuses from gestational diabetic mothers (GDM), representing different intrauterine growth patterns. Umbilical venous plasma leptin concentrations were determined at the time of either in utero fetal blood sampling or delivery. Plasma leptin was measurable as early as 19 wk of gestation. A significant difference was observed between umbilical venous and arterial plasma leptin concentrations (0.6 +/- 0.6 ng/mL; p < 0.01). In AGA and in IUGR fetuses, significant positive relationships were found between fetal leptin concentrations and both gestational age (p < 0.001) and fetal weight (p < 0.001). Leptin concentrations were significantly higher in AGA than IUGR only after 34 wk (p < 0.05), but leptin per kilogram fetal weight (leptin/kg) was not significantly different. In IUGR with abnormal umbilical arterial Doppler velocimetry and fetal heart rate, leptin/kg significantly higher than in IUGR with normal biophysical and biochemical parameters was found (p < 0.05). Both circulating plasma leptin and leptin/kg were significantly higher in GDM than in normal fetuses (p < 0.001) and correlated with abdominal fat mass measured by ultrasound. No gender differences were observed in any group of fetuses. These findings indicate a clear relationship between fetal leptin concentrations and fetal fat mass. Data in severe IUGR suggest the presence of increased leptin concentrations associated with in utero signs of fetal distress.