임신성 당뇨병 및 임신성 고혈압 산모와 신생아의 임상적 특징과 제대혈 아디포넥틴과 레지스틴 농도의 상관성
Correlation of Clinical Characteristics and Levels of Adiponectin and Resistin in Human Cord Blood of Fetuses of Women with Gestational Diabetes and Pregnancy-induced Hypertension
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목 적: 인슐린 저항성과 관련이 있는 임신 합병증인 임신성 당뇨와 임신성 고혈압 산모에서 관련된 adipokines인 아디포넥틴과 레지스틴의 제대혈 농도를 측정하여 대상 산모 및 신생아 특성과의 상관성을 알아보고자 하였다. 방 법: 2006년 3월부터 2008년 3월까지 조선대 병원에 입원한 정상 임신 및 임신과 관련된 합병증이 있는 산모(정상 46명, 임신성 고혈압 20명, 임신성 당뇨 14명)에서 태어난 80명의 신생아(남아 36명, 여아 44명, 재태 기간 26-41주)를 대상으로 하였다. 대상 산모와 신생아의 신체 계측을 시행하고, 출생 즉시 제대혈을 채취하여 아디포넥틴과 레지스틴 농도를 측정하였다. 결 과: 1) SGA군은 AGA군보다 출생체중, ponderal index 및 레지스틴 농도가 유의하게 낮았다(P˂0.05). 2) LGA군의 산모 체중, BMI, 출생체중, 신장과 ponderal index는 AGA군과 SGA군보다 유의하게 높았다(P˂0.05). 3) LGA군의 아디포넥틴 농도는 AGA군과 SGA군보다 낮았고, 레지스틴 농도는 SGA군보다 유의하게 높았다(P˂0.05). 4)PIH군에서 정상 대조군보다 산모체중, BMI, 출생체중, 신장 및 레지스틴 농도가 유의하게 낮았다(P˂0.05). 5) GDM군은 정상 대조군과 PIH군보다 산모체중, BMI, 출생체중 및 ponderal index가 유의하게 높았다(P˂0.05). 6)GDM군의 아디포넥틴 농도는 정상 대조군과 PIH군보다 유의하게 낮았고, 레지스틴 농도는 PIH군보다 유의하게 높았다(P˂0.05). 7)아디포넥틴 농도는 Ponderal index, HbA1c 및 BMI와 음의 상관성이 있고, 임신 주수와는 양의 상관성이 있었다. 8) 레지스틴 농도는 출생체중 및 BMI와 양의 상관관계를 보였다. 결 론: 제대혈 adiponectin과 레지스틴 농도 변화는 임신 합병증과 관련 있었으며, 특히 임신 합병증 산모에서 태어난 신생아와 부당 중량아 및 부당 경량아는 향후 인슐린 저항성 발생 여부에 대한 추적 관찰이 필요할 것으로 생각된다.
Abstract
Purpose: Adiponectin and resistin are potent regulators of glucose homeostasis and energy metabolism. In this study, we aimed to determine (1) the role of gestational diabetes (GDM) and pregnancy-induced hypertension (PIH) on the plasma levels of adiponectin and resistin in cord blood, and (2) the association of the hormones with anthropometric parameters at birth. Methods: This study investigated 80 pregnant women at 26–41 weeks of gestation, including 46 healthy pregnant woman as controls; 14 women with GDM; and 20 women with PIH, and 80 newborn infants (36 male, and 44 female). The following anthropometric measurements were obtained: maternal weight, length, body mass index (BMI), neonatal birth weight, neonatal length, and ponderal index. Cord blood samples were obtained from 80 neonates at the time of delivery. Plasma adiponectin levels (RIA) and resistin levels (ELISA) were measured. Results: Adiponectin levels were significantly lower in the fullterm group with GDM and fullterm group with PIH than the control group. Plasma resistin levels were significantly lower in the preterm and the fullterm groups with PIH than in the control group, and significantly higher in the fullterm group with GDM than in the PIH group. Similarly, adiponection was significantly lower in large for gestational age (LGA) infants than appropriate gestational age (AGA) and small for gestational age (SGA) infants, and resistin was significantly higher in LGA infants than in SGA infants. Adiponectin levels were negatively correlated with ponderal index, maternal HbA1c, and maternal body mass index (BMI). Plasma resistin levels were positively correlated with birth weight and maternal BMI. Conclusion: Alteration of adiponectin and resistin levels in cord blood of fetuses of women with GDM and PIH may influence the development of metabolic disorders at all stages of development.
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