摘要
目的探讨脐血氨基酸与新生儿出生体重之间的关联,并评价氨基酸作为胎儿宫内生长和营养状况指标的价值。方法选择2021年6—9月在江苏省丹阳市人民医院就诊并住院分娩的87名母婴为研究对象。从医院电子病历系统获取孕产妇基本信息、分娩孕周、新生儿出生体重等信息。采用LC-MS/MS技术测定脐血中天冬酰胺、天冬氨酸、赖氨酸、谷氨酰胺等21种氨基酸水平。采用IBM SPSS Statistics 26.0统计学软件进行回归分析,明确脐血营养素对出生体重影响效应的大小。结果单因素分析结果显示,脐血中天冬酰胺、谷氨酰胺、色氨酸、脯氨酸和异亮氨酸的水平与新生儿出生体重相关,相关氨基酸的水平每变化1μg/ml,新生儿出生体重分别增加104.51 g(95%CI:8.18~200.48)、10.88 g(95%CI:0.40~21.36)、72.61g(95%CI:22.19~123.04)、31.47 g(95%CI:1.25~61.69)和14.40 g(95%CI:0.99~27.80);巨大儿方面,天冬酰胺、脯氨酸和异亮氨酸分别与巨大儿风险增加6%(OR=1.06,95%CI:1.00~1.12)、2%(OR=1.02,95%CI:1.00~1.04)和1%(OR=1.01,95%CI:1.00~1.02)相关,而组氨酸则与巨大儿风险下降4%(OR=0.96,95%CI:0.93~0.99)相关;大于胎龄儿方面,脯氨酸与大于胎龄儿风险升高2%(OR=1.02,95%CI:1.00~1.04)相关,而组氨酸则与巨大儿风险下降4%(OR=0.96,95%CI:0.93~0.99)相关。进一步调整年龄、孕前BMI等协变量后,天冬酰胺以及色氨酸的水平与新生儿出生体重存在关联,天冬酰胺和色氨酸每变化1μg/ml,新生儿出生体重分别增加92.36 g(95%CI:6.43~178.29)和47.03 g(95%CI:3.06~91.00)。对于巨大儿而言,组氨酸以及异亮氨酸的浓度与其发生风险相关,组氨酸每变化1μg/ml,巨大儿风险降低4%(OR=0.96,95%CI:0.93~0.99),异亮氨酸每变化1μg/ml,巨大儿风险升高1%(OR=1.01,95%CI:1.00~1.02);对于大于胎龄儿而言,组氨酸的浓度与其发生风险降低相关,组氨酸每变化1μg/ml,巨大儿风险降低4%(OR=0.96,95%CI:0.92~0.99)。结论脐血中的天冬酰胺、色氨酸、组氨酸和异亮氨酸等可能与胎儿宫内生长、新生儿出生体重之间存在关联。
Objective To investigate the association between umbilical cord blood amino acids and neonatal birth weight,and to evaluate their potential as biomarkers for fetal intrauterine growth and nutritional status.Methods Eighty-seven mother-infant pairs delivering at Danyang People's Hospital,Jiangsu Province,China,from June to September 2021 were enrolled as study subjects.Maternal demographics,gestational age,and neonatal birth weight were extracted from the electronic medical record system.Twenty-one amino acids(e.g.,asparagine,aspartic acid,lysine,glutamine,tryptophan)in cord blood were quantified using liquid chromatography-tandem mass spectrometry(LC-MS/MS).Regression analyses were performed using IBM SPSS Statistics 26.0 to assess the effect sizes of amino acids on birth weight.Results Univariate analysis demonstrated that umbilical cord blood levels of asparagine,glutamine,tryptophan,proline,and isoleucine were associated with neonatal birth weight.Each 1μg/ml increase in these amino acids corresponded to birth weight increments of 104.51 g(95%CI:8.18-200.48),10.88 g(95%CI:0.40-21.36),72.61 g(95%CI:22.19-123.04),31.47 g(95%CI:1.25-61.69),and 14.40 g(95%CI:0.99-27.80),respectively.For macrosomia,asparagine,proline,and isoleucine concentrations showed significant associations.A 1μg/ml increment in asparagine,proline,and isoleucine was linked to a 6%(OR=1.06,95%CI:1.00-1.12),2%(OR=1.02,95%CI:1.00-1.04),and 1%(OR=1.01,95%CI:1.00-1.02)increase in macrosomia risk,respectively,while a 1μg/ml increase in histidine corresponded to a 4%(OR=0.96,95%CI:0.93-0.99)reduction in macrosomia risk.For large-for-gestational-age(LGA)infants,a 1μg/ml increment in proline was linked to a 2%(OR=1.02,95%CI:1.00-1.04)increase in LGA risk,while a 1μg/ml increase in histidine corresponded to a 4%(OR=0.96,95%CI:0.93-0.99)reduction in macrosomia risk.For large-for-gestational-age(LGA)infants,a 1μg/ml increment in proline was linked to a 2%(OR=1.02,95%CI:1.00-1.04)increasement in LGA risk,histidine levels were inversely associated with large-for-gestational-age(LGA)infants,with each 1μg/ml rise reducing LGA risk by 4%(OR=0.96,95%CI:0.93–0.99).After adjusting for covariates such as maternal age and pre-pregnancy BMI,the associations persisted.Asparagine and tryptophan remained positively correlated with birth weight(92.36 g and 47.03 g increases per 1μg/ml,respectively).For macrosomia,histidine and isoleucine concentrations were associated with its occurrence risk.A 1μg/ml increment in histidine corresponded to a 4%(OR=0.96,95%CI:0.93-0.99)reduction in macrosomia risk,while a 1μg/ml increase in isoleucine elevated the risk by 1%(OR=1.01,95%CI:1.00-1.02).For large-for-gestational-age(LGA)infants,histidine levels showed an inverse association with risk,where each 1μg/ml rise reduced LGA risk by 4%(OR=0.96,95%CI:0.92-0.99).Conclusions The asparagine,tryptophan,histidine and isoleucine in umbilical cord blood may be associated with intrauterine fetal growth and neonatal birth weight.
作者
戴楠
徐云钊
陈晨
汤艺
胥静雯
钱家慧
Dai Nan;Xu Yunzhao;Chen Chen;Tang Yi;Xu Jingwen;Qian Jiahui(The People's Hospital of Danyang,Danyang People's Hospital Affiliated to Nantong University,Zhenjiang,Jiangsu 212300,China;The Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China)
出处
《齐齐哈尔医学院学报》
2025年第16期1535-1541,共7页
Journal of Qiqihar Medical University
基金
镇江市社发项目(FZ2023007)。
关键词
脐血
氨基酸
出生体重
巨大儿
大于胎龄儿
Umbilical cord blood
Amino acids
Birth weight
Macrosomia
Large-for-gestational-age
