The Research On The Relationship Between Ghrelin And Both Fetal And Neonatal Growth Parameters, Energy Balance And Insulin Sensitivity

ObjectiveThe aim of this study was to evaluate whether plasma ghrelin concentrations were different in low birth weight infants compared with normal birth weight infants,the correlation to anthropometric measurements and the variations at delivery and the fifth day after birth.We also evaluated the relationship of ghrelin,insulin,glucose and insulin resistance.Investigate the mechanism and influence of ghrelin in energy homeostasis and growth during fetal and neonatal life,and in the development of perinatal insulin resistance metabolic syndrome in low birth weight group.MethodAccording to the weight of birth,the neonates were divided into two groups:low birth weight and normal birth weight.The weight,height,head circumference,chest circumference,the weight of placenta,glucose,ghrelin and insulin were measured just after birth and the fifth day after birth.The intake of nutritions and the changes of weight were record,Kaup index,insulin sensitive and insulin resistance index were calculated.Compare relationship between two groups of ghrelin,birth weight,height, head circumference,chest circumference,the weight of placenta,glucose,insulin, insulin sensitive and resistance index.Compare the correlation of plasma ghrelin,weight,height,head circumference,chest circumference,average energy intake of everyday and the speed of weight increase.Compare the variation of plasma ghrelin,glucose and insulin between birth and the fifth day after birth.Result1 Umbilical cord ghrelin concentrations in group of low birth weight were negatively correlated with birth weights,height,head circumference,the weight of placenta,kaup index(P＜0.05),But were not significantly correlated with chest circumference and gestational age(P＞0.05).Umbilical cord ghrelin concentrations in group of normal birth weight were negatively correlated with birth weigh and head circumference(P＜0.05),but were not correlated with height,chest circumference, gestational age,the weight of placenta,and kaup index(P＞0.05).2 The umbilical cord ghrelin levels in group of low birth weight were negatively correlated with insulin and insulin resistance index,positively with insulin sensitive index,no correlation with glucose;The umbilical cord ghrelin levels in group of normal birth weight were negatively correlated with insulin and no correlation with insulin sensitive,insulin resistance index and glucose.Insulin levels and insulin resistance index in group of low birth weight were lower than in normal group's;ghrelin and insulin sensitive index were inversed,no difference in glucose.3 In two groups,the plasma ghrelin levels and glucose in the fifth day after birth were higher than in cord blood,the insulin levels were inversed.The plasma ghrelin levels in group of low birth weight is distinctively higher than in group of normal birth weight both of the cord blood and the fifth day's after birth,the insulin levels were inversed.4 The plasma ghrelin of the fifth day after birth in group of low birth weight were negatively correlated with birth weight and kaup index,but not obviously correlated with height,head circumference and chest circumference.They were also negatively correlated with the weight of that day,but were not obviously correlated with kaup index,average energy intake of everyday and the speed of weight increase.The plasma ghrelin of the fifth day after birth in the group of normal birth weight were negatively correlated with birth weight,not obviously correlated with height,head circumference,chest circumference and kaup index;they were negatively correlated with the weight of that day and average energy intake of everyday,but not with height, kaup index of that day and the speed of weight increase.Conclusion1 The cord ghrelin concentrations were negatively correlated with anthropometric measurements at birth,espeserly in low birth weight group.The ghrelin levels in low birth weight were higher than normal birth weight.The ghrelin may be an important regulated factors in neonatal growth.2 In two groups,the plasma ghrelin levels in the fifth day after birth were higher than in cord blood,the plasma ghrelin levels in group of low birth weight is distinctively higher than in group of normal birth weight in the fifth day's after birth.It suggest that the ghrelin also contributed to energy balance and growth after birth,and might affect catch up growth in low birth weight neonates.3 The relationship between ghrelin and insulin resistance menifests more deeply that: ghrelin participates with the process of insulin resistance in the low birth weight group.And it probably prevent insulin resistance,prevent or delay the development of relative disease.