Leptin, insulin, insulin-like growth factors and their binding proteins in cord serum: insight into fetal growth and discordancy
Leptin, insulin, insulin-like growth factors and their binding proteins in cord serum: insight into fetal growth and discordancy
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DOI：
10.1111/j.1365-2265.2006.02632.x
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发表时间：
2006-11-01
影响因子：
3.2
通讯作者：
Shtaif, B.
中科院分区：
文献类型：
--
作者：
Davidson, S.;Hod, M.;Shtaif, B.
目的宫内生长受限的单胎婴儿具有适应性的内分泌特征，其特征是IGF-1、IGF-2、IGFBP-3和胰岛素水平降低，IGFBP-1和IGFBP-2水平升高。本研究检测了双胞胎出生时脐带血清中六种生长因子水平与人体测量学特征之间的关系，以确定宫内生长因子的相互作用，并描述小的不协调双胞胎的特定激素特征。设计流行病例对照研究。测量出生时脐血IGF-1、IGF-2、IGFBP-1、IGFBP-3、胰岛素、瘦素水平和人体测量值。结果在不一致组和一致组中，体型较小的双生子的IGF-1水平显著低于体型较大的双生子（P < 0.03），而IGFBP-1水平显著高于体型较大的双生子（P < 0.02）。IGFBP-1与IGF-1呈负相关（P < 0.05）。胰岛素水平在较小不一致双胞胎中显著高于较小一致双胞胎（P < 0.001），在较大不一致双胞胎中显著高于较大一致双胞胎（P < 0.004）。单卵双生子中，体型较大的不协调双生子血清瘦素水平显著高于体型较大的一致双生子（P < 0.025）。出生体重不一致率与IGF-1和IGFBP-1的双胎差异相关。结论在所研究的6个因素中，IGF-1可能是宫内生长的主要指标。双胞胎不和谐可能涉及代偿机制而不是适应机制或多激素相对抵抗综合征。
Objective Singleton infants with intrauterine growth restriction have an adaptive hormonal profile characterized by decreased levels of IGF-1, IGF-2, IGFBP-3 and insulin and elevated levels of IGFBP-1 and IGFBP-2. This study examined the association between cord serum levels of six growth factors and anthropometric features at birth in twins in order to determine the intrauterine growth factor interactions and to characterize the specific hormonal profile of small discordant twins.Design Prevalent case-control study.Patients Twenty pairs of discordant twins (5 monozygotic, 15 dizygotic) and 20 pairs of concordant twins (6 monozygotic, 14 dizygotic) matched for gestational age.Measurements Cord blood levels of IGF-1, IGF-2, IGFBP-1, IGFBP-3, insulin, leptin and anthropometric measurements at birth. Intra- and inter-pair differences and correlation coefficients were calculated, and the data were fitted to multivariate regression models.Results In both discordant and concordant groups, the smaller twins had a significantly lower level of IGF-1 (P < 0.03) and significantly higher level of IGFBP-1 (P < 0.02) than their larger cotwins. IGFBP-1 was inversely correlated with IGF-1 (P < 0.05). Insulin levels were significantly higher in the smaller discordant than the smaller concordant twins (P < 0.001) and in the larger discordant than the larger concordant twins (P < 0.004). Among the monozygotic twins, the leptin level was significantly higher in the larger discordant than the larger concordant twins (P < 0.025). Percentage birth weight discordancy was statistically correlated with twin-pair differences in IGF-1 and IGFBP-1.Conclusions Of the six factors studied, IGF-1 appears to be the main indicator of intrauterine growth. Twin discordancy may involve compensatory rather than adaptive mechanisms or a multihormone relative resistance syndrome.