出生狀況與新生兒糖脂代謝指標(biāo)的相關(guān)性研究
發(fā)布時(shí)間：2018-10-17 12:19
【摘要】：研究目的：基于“健康與疾病的發(fā)育起源”假說,了解新生兒的出生狀況和新生兒臍血糖脂代謝指標(biāo)的基本情況,研究新生兒不同出生狀況與新生兒臍血各項(xiàng)糖脂代謝指標(biāo)之間的關(guān)系,分析并確定新生兒不同出生狀況與新生兒臍血各項(xiàng)糖脂代謝指標(biāo)的相關(guān)性,為今后進(jìn)一步探索出生時(shí)狀況和生命早期糖脂代謝水平、兒童期生長(zhǎng)發(fā)育和糖脂代謝水平,與代謝綜合征及成人肥胖癥、糖尿病、心腦血管疾病的關(guān)系打下初步基礎(chǔ)。研究方法：以2013年10月-2015年10月在浙江省金華市婦幼保健院出生的全部新生兒為研究對(duì)象。對(duì)符合標(biāo)準(zhǔn)的新生兒進(jìn)行出生狀況調(diào)查和臍血糖脂代謝指標(biāo)檢測(cè)。收集數(shù)據(jù)后進(jìn)行統(tǒng)計(jì)學(xué)分析。全部資料使用Epidata 3.1軟件進(jìn)行數(shù)據(jù)錄入,采用SPSS20.0版軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,統(tǒng)計(jì)學(xué)方法包括：統(tǒng)計(jì)描述,t檢驗(yàn),單因素方差分析,LSD檢驗(yàn),Pearson相關(guān)和秩相關(guān)、多重線性回歸,以α=0.05為檢驗(yàn)顯著性標(biāo)準(zhǔn)。研究結(jié)果：1.3665例新生兒性別構(gòu)成男性居多,共1989例(54.3%),女性1676例(45.7%)；低出生體重49例(1.3%),正常出生體重3447例(94.1%),高出生體重兒169例(4.6%)；早產(chǎn)兒78例(2.1%),足月兒3581例(97.7%),過期產(chǎn)兒6例(0.2%)；胎齡別出生體重分組,SGA 79例(2.2%),AGA 2449例(66.8%),LGA 1137例(31%);出生方式以剖宮產(chǎn)最多,共1929例(52.6%),順產(chǎn)1671例(45.6%)。2.3665例臍血樣本中,7項(xiàng)脂代謝指標(biāo)和3項(xiàng)糖代謝指標(biāo)平均值均較普通人群參考值明顯偏低,低于參考值的人數(shù)占總體的比例很高。3.單因素分析：t檢驗(yàn)顯示：不同性別新生兒在ApoA1、ApoB、HDL-C、LDL-C、TC、 Ins指標(biāo)的分布有顯著差異(P0.05)；不同出生方式新生兒在所有糖脂代謝指標(biāo)的分布有顯著差異(P0.05);不同臍帶、羊水分娩情況的新生兒在HDL-C、TC、C肽指標(biāo)的分布有顯著差異(P0.05)。方差分析顯示：早產(chǎn)兒、足月產(chǎn)兒、過期產(chǎn)兒三組的LDL-C與TC有顯著差異(P0.05)；LBW、NBW、HBW三組的ApoA1、HDL-C、C肽、Ins具有顯著差異(P0.05)；SGA、AGA、LGA三組的ApoA1、HDL-C、TC、TG、C肽、Ins具有顯著差異(P0.05)。4.多重線性回歸發(fā)現(xiàn),出生方式對(duì)ApoA1、ApoB、Lpa、TG、HbA1c、Ins影響最大,性別對(duì)HDL-C、LDL-C、TC影響最大,胎齡別出生體重對(duì)C肽影響最大。結(jié)論：(1)性別、胎齡別出生體重等出生狀況是影響新生兒糖脂代謝指標(biāo)的重要因素;(2)女嬰LDL-C、TC的水平明顯高于男嬰；(3)新生兒臍血LDL-C、TG與出生體重呈負(fù)相關(guān),低出生體重兒臍血LDL-C水平偏高,臍血TG水平在SGA組明顯升高；(4)臍血C肽、胰島素的水平隨著新生兒出生體重的增加而升高,與胎齡別出生體重呈正相關(guān),提示LGA可能是發(fā)生新生兒高C肽、高胰島素血癥的的危險(xiǎn)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.
【學(xué)位授予單位】：杭州師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：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.
【學(xué)位授予單位】：杭州師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R722.1
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