出生状况与新生儿糖脂代谢指标的相关性研究
发布时间：2018-10-17 12:19
【摘要】：研究目的：基于“健康与疾病的发育起源”假说,了解新生儿的出生状况和新生儿脐血糖脂代谢指标的基本情况,研究新生儿不同出生状况与新生儿脐血各项糖脂代谢指标之间的关系,分析并确定新生儿不同出生状况与新生儿脐血各项糖脂代谢指标的相关性,为今后进一步探索出生时状况和生命早期糖脂代谢水平、儿童期生长发育和糖脂代谢水平,与代谢综合征及成人肥胖症、糖尿病、心脑血管疾病的关系打下初步基础。研究方法：以2013年10月-2015年10月在浙江省金华市妇幼保健院出生的全部新生儿为研究对象。对符合标准的新生儿进行出生状况调查和脐血糖脂代谢指标检测。收集数据后进行统计学分析。全部资料使用Epidata 3.1软件进行数据录入,采用SPSS20.0版软件进行统计学分析,统计学方法包括：统计描述,t检验,单因素方差分析,LSD检验,Pearson相关和秩相关、多重线性回归,以α=0.05为检验显著性标准。研究结果：1.3665例新生儿性别构成男性居多,共1989例(54.3%),女性1676例(45.7%)；低出生体重49例(1.3%),正常出生体重3447例(94.1%),高出生体重儿169例(4.6%)；早产儿78例(2.1%),足月儿3581例(97.7%),过期产儿6例(0.2%)；胎龄别出生体重分组,SGA 79例(2.2%),AGA 2449例(66.8%),LGA 1137例(31%);出生方式以剖宫产最多,共1929例(52.6%),顺产1671例(45.6%)。2.3665例脐血样本中,7项脂代谢指标和3项糖代谢指标平均值均较普通人群参考值明显偏低,低于参考值的人数占总体的比例很高。3.单因素分析：t检验显示：不同性别新生儿在ApoA1、ApoB、HDL-C、LDL-C、TC、 Ins指标的分布有显著差异(P0.05)；不同出生方式新生儿在所有糖脂代谢指标的分布有显著差异(P0.05);不同脐带、羊水分娩情况的新生儿在HDL-C、TC、C肽指标的分布有显著差异(P0.05)。方差分析显示：早产儿、足月产儿、过期产儿三组的LDL-C与TC有显著差异(P0.05)；LBW、NBW、HBW三组的ApoA1、HDL-C、C肽、Ins具有显著差异(P0.05)；SGA、AGA、LGA三组的ApoA1、HDL-C、TC、TG、C肽、Ins具有显著差异(P0.05)。4.多重线性回归发现,出生方式对ApoA1、ApoB、Lpa、TG、HbA1c、Ins影响最大,性别对HDL-C、LDL-C、TC影响最大,胎龄别出生体重对C肽影响最大。结论：(1)性别、胎龄别出生体重等出生状况是影响新生儿糖脂代谢指标的重要因素;(2)女婴LDL-C、TC的水平明显高于男婴；(3)新生儿脐血LDL-C、TG与出生体重呈负相关,低出生体重儿脐血LDL-C水平偏高,脐血TG水平在SGA组明显升高；(4)脐血C肽、胰岛素的水平随着新生儿出生体重的增加而升高,与胎龄别出生体重呈正相关,提示LGA可能是发生新生儿高C肽、高胰岛素血症的的危险因素。
[Abstract]:Objective: based on the hypothesis of "Health and the origin of disease", to understand the birth status of newborns and the basic status of glucose and lipid metabolism in umbilical cord blood of newborns. To study the relationship between different birth conditions of newborns and the indexes of glucose and lipid metabolism in umbilical cord blood of newborns, and to analyze and determine the correlation between the different birth conditions of newborns and the indexes of glucose and lipid metabolism in umbilical cord blood of newborns. To further explore the status of birth and early life level of glucose and lipid metabolism, childhood growth and lipid metabolism, and metabolic syndrome and adult obesity, diabetes, cardiovascular and cerebrovascular diseases. Methods: all the newborns born in Jinhua Maternal and Child Health Hospital of Zhejiang Province from October 2013 to October 2015 were taken as the research objects. Neonatal birth status and umbilical blood glucose and lipid metabolism were investigated. Collect data for statistical analysis. All data were inputted by Epidata 3.1 software and analyzed by SPSS20.0 software. The statistical methods included: statistical description, t test, single factor variance analysis, LSD test, Pearson correlation and rank correlation, multiple linear regression. A = 0.05 was taken as the test standard of significance. The results showed that 1989 (54.3%) were male, 1676 (45.7%) were female, 49 (1.3%) were low birth weight, 3447 (94.1%) were normal birth weight, 169 (4.6%) were high birth weight, 78 (2.1%) were premature, 3581 (97.7%) were full-term, 6 (0.2%) were overdue. There were 79 cases of SGA (2.2%), AGA 2449 cases, 66.8%), LGA 1137 cases, 31%), 1929 cases of cesarean section (52.6%), 1671 cases of natural birth (45.6%), 2.3665 cases of umbilical cord blood samples. The proportion of people below the reference value is high. 3. 3. Univariate analysis: t test showed that there were significant differences in the distribution of ApoA1,ApoB,HDL-C,LDL-C,TC, Ins indexes among different sex newborns (P0.05); there were significant differences in the distribution of all glucose and lipid metabolism indexes among the newborns with different birth patterns (P0.05); different umbilical cord, different umbilical cord, The distribution of HDL-C,TC,C peptide in amniotic fluid delivery neonates was significantly different (P0.05). Analysis of variance showed that LDL-C and TC in premature infants, term infants and expired infants were significantly different (P0.05); ApoA1,HDL-C,C peptide and Ins in LBW,NBW,HBW group were significantly different (P0.05); ApoA1,HDL-C,TC,TG,C peptide and Ins in SGA,AGA,LGA group had significant difference (P0.05). Multiple linear regression analysis showed that birth style had the greatest influence on ApoA1,ApoB,Lpa,TG,HbA1c,Ins, sex had the greatest influence on HDL-C,LDL-C,TC, and gestational age and birth weight had the greatest influence on C-peptide. Conclusion: (1) Sex, gestational age, birth weight and other birth conditions are important factors influencing the metabolism of glucose and lipid in newborn, (2) the level of LDL-C,TC in female infants is significantly higher than that in male infants, (3) there is a negative correlation between neonatal umbilical cord blood LDL-C,TG and birth weight. The level of LDL-C in cord blood of low birth weight infants was higher, and the level of TG in cord blood was significantly higher in SGA group. (4) the levels of C peptide and insulin in umbilical cord blood increased with the increase of birth weight, and were positively correlated with the birth weight at different birth age. The results suggest that LGA may be a risk factor for neonatal hypercaptopeptide and hyperinsulinemia.
【学位授予单位】：杭州师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R722.1
[Abstract]:Objective: based on the hypothesis of "Health and the origin of disease", to understand the birth status of newborns and the basic status of glucose and lipid metabolism in umbilical cord blood of newborns. To study the relationship between different birth conditions of newborns and the indexes of glucose and lipid metabolism in umbilical cord blood of newborns, and to analyze and determine the correlation between the different birth conditions of newborns and the indexes of glucose and lipid metabolism in umbilical cord blood of newborns. To further explore the status of birth and early life level of glucose and lipid metabolism, childhood growth and lipid metabolism, and metabolic syndrome and adult obesity, diabetes, cardiovascular and cerebrovascular diseases. Methods: all the newborns born in Jinhua Maternal and Child Health Hospital of Zhejiang Province from October 2013 to October 2015 were taken as the research objects. Neonatal birth status and umbilical blood glucose and lipid metabolism were investigated. Collect data for statistical analysis. All data were inputted by Epidata 3.1 software and analyzed by SPSS20.0 software. The statistical methods included: statistical description, t test, single factor variance analysis, LSD test, Pearson correlation and rank correlation, multiple linear regression. A = 0.05 was taken as the test standard of significance. The results showed that 1989 (54.3%) were male, 1676 (45.7%) were female, 49 (1.3%) were low birth weight, 3447 (94.1%) were normal birth weight, 169 (4.6%) were high birth weight, 78 (2.1%) were premature, 3581 (97.7%) were full-term, 6 (0.2%) were overdue. There were 79 cases of SGA (2.2%), AGA 2449 cases, 66.8%), LGA 1137 cases, 31%), 1929 cases of cesarean section (52.6%), 1671 cases of natural birth (45.6%), 2.3665 cases of umbilical cord blood samples. The proportion of people below the reference value is high. 3. 3. Univariate analysis: t test showed that there were significant differences in the distribution of ApoA1,ApoB,HDL-C,LDL-C,TC, Ins indexes among different sex newborns (P0.05); there were significant differences in the distribution of all glucose and lipid metabolism indexes among the newborns with different birth patterns (P0.05); different umbilical cord, different umbilical cord, The distribution of HDL-C,TC,C peptide in amniotic fluid delivery neonates was significantly different (P0.05). Analysis of variance showed that LDL-C and TC in premature infants, term infants and expired infants were significantly different (P0.05); ApoA1,HDL-C,C peptide and Ins in LBW,NBW,HBW group were significantly different (P0.05); ApoA1,HDL-C,TC,TG,C peptide and Ins in SGA,AGA,LGA group had significant difference (P0.05). Multiple linear regression analysis showed that birth style had the greatest influence on ApoA1,ApoB,Lpa,TG,HbA1c,Ins, sex had the greatest influence on HDL-C,LDL-C,TC, and gestational age and birth weight had the greatest influence on C-peptide. Conclusion: (1) Sex, gestational age, birth weight and other birth conditions are important factors influencing the metabolism of glucose and lipid in newborn, (2) the level of LDL-C,TC in female infants is significantly higher than that in male infants, (3) there is a negative correlation between neonatal umbilical cord blood LDL-C,TG and birth weight. The level of LDL-C in cord blood of low birth weight infants was higher, and the level of TG in cord blood was significantly higher in SGA group. (4) the levels of C peptide and insulin in umbilical cord blood increased with the increase of birth weight, and were positively correlated with the birth weight at different birth age. The results suggest that LGA may be a risk factor for neonatal hypercaptopeptide and hyperinsulinemia.
【学位授予单位】：杭州师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R722.1
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