Elevated umbilical cord ghrelin concentrations in small for gestational age neonates
Elevated umbilical cord ghrelin concentrations in small for gestational age neonates
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DOI：
10.1210/jc.2003-030265
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发表时间：
2003-09-01
影响因子：
5.8
通讯作者：
Chanoine, JP
中科院分区：
文献类型：
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作者：
Farquhar, J;Heiman, M;Chanoine, JP
Ghrelin具有促食欲作用。它存在于足月新生儿的脐带血浆中，提高了ghrelin在胎儿和新生儿能量平衡中发挥作用的前景。我们测量了小胎龄（SGA）、适当胎龄（阿加）和大胎龄（LGA）新生儿的生长激素释放肽，并评估生长激素释放肽水平是否受新生儿胰岛素和葡萄糖浓度的调节。对123例SGA、阿加和LGA新生儿（胎龄，24-41周）出生时采集的脐带血中生长激素释放肽、胰岛素和葡萄糖的血浆浓度进行了测定，这些新生儿的母亲患有或不患有糖尿病。在所有婴儿的样本中都检测到Ghrelin。与阿加（1738 +/- 380）和LGA（1723 +/- 269）新生儿相比，SGA新生儿中其浓度（平均值+/- SD，2436 +/- 657 pg/ml）高40%。阿加/LGA组ghrelin与孕周呈正相关（r = 0.23; P < 0.05），SGA组ghrelin与孕周呈负相关（r = -0.67; P < 0.005）。因此，SGA和阿加/LGA新生儿之间ghrelin的差异随着胎龄的增加而减小。出生体重z评分、母亲高血压和血糖浓度是生长激素释放肽浓度的重要决定因素。总之，SGA新生儿的脐带ghrelin血浆浓度高于阿加/LGA新生儿。Ghrelin可能在胎儿适应宫内营养不良中发挥生理作用。
Ghrelin has orexigenic effects. It is present in umbilical cord plasma in full-term neonates, raising the prospect that ghrelin plays a role in fetal and neonatal energy balance. We measured ghrelin in small (SGA), appropriate (AGA), and large (LGA) for gestational age neonates and evaluated whether ghrelin levels are modulated by neonatal insulin and glucose concentrations. Plasma concentrations of ghrelin, insulin, and glucose were measured in cord blood sampled at birth in 123 SGA, AGA, and LGA neonates (gestational age, 24-41 wk) born to mothers with and without diabetes. Ghrelin was detected in samples from all infants. Its concentration was 40% higher in SGA neonates (mean +/- SD, 2436 +/- 657 pg/ml) compared with AGA (1738 +/- 380) and LGA (1723 +/- 269) neonates. There was a positive correlation between ghrelin and gestational age in AGA/LGA (r = 0.23; P < 0.05) and a negative correlation in SGA (r = -0.67; P < 0.005) neonates. Therefore, the difference in ghrelin between SGA and AGA/LGA neonates decreases with advancing gestational age. Birth weight z-score, maternal hypertension, and glucose concentrations were significant determinants of ghrelin concentrations. In conclusion, SGA neonates present with higher umbilical cord ghrelin plasma concentrations than AGA/LGA neonates. Ghrelin may play a physiological role in fetal adaptation to intrauterine malnutrition.