妊娠 末期 임부에서 태어난 신생아 臍帶血 인슐린(Insulin)에 대한 변화

Abstract

1985년 1월부터 3월까지 이화여자대학교 의과대학 부속병원 산부인과에 입원한 임부중 탄수화물대사에 장애가 없고 기타 합병증이 없는 45예에서 신생아 제대혈 인슐린치를 radioimmunoassay 방법으로 측정, 분석 관찰하여 다음과 같은 결과를 얻었다. 1. 임신주수에 따라서 제대혈 인슐린평균치는, 통계학적으로는 유의하지 않았으나, 임신주수가 증가될수록 인슐린치도 증가되는 경향이 있었다 (34∼37주時 5.8±0.3 μu/ml, 38∼4l주時 6.9±0.7 μu/ml, 42∼43주時에는 8.6±2.2 μu/ml). 2. 출생 체중별에 따른 신생아 제대혈 인슐린 평균치도, 2500g이하時 4.6±1.1 μu/ml, 2500g이상 4000g미만인 경우는 7.3.±0.7 μu/ml, 4000g이상에서는 13.2±4.2 μu/ml로 체중이 증가될수록, 인슐린치도 증가되는 경향이 있었으나, 통계학적으로는 유의한 차이를 보이지 않았다. 3. 출생체중 백분위수(percentiles)별로 본 제대혈 인슐린치도 percentiles이 증가할수록 대체로 상승하는 경향을 보였다(10th percentiles 時 6.7±1.9 μu/ml, 50th percentiles 時 6.8±0.7 μu/ml에 비하여 90th percentiles 時에는 9.2±2.1 μu/ml), 임신말기의 임부에서 태어난 신생아 제대혈 인슐린치는 주수별로 점차 증가되며, 또한 체중 증가에 따라서 점진적으로 증가하는 추세였으나, 통계학적으로는 그다지 의의가 없었다.;Pregnancy itself is diabetogenic. If the mother's carbohydrate metabolism was disturbed during pregnancy, neonatal overweight may result from fetal hyperinsulinism. This can be confirmed by determining the insulin in the umbilical cord blood. The data presented are based on 45 cases' insulin values for the umbilical cord blood of healthy neonates of late pregnancy. In this paper the mean insulin level in the cord blood of term neonates, and the relationship between the insulin levels and various advancing degree of the gestational weeks or various percentiles of birth weight. In method, blood samples drawn from umbilical cord vein of 45 healthy neonates of late pregnancy were centrifused and the plasma was removed and frozen at -2O℃ was analysed by means of sol id phase radioimmunoassay technic(Dainabot, Japan), The sensitivity of assay provided as 5 μu/ml. The results obtained were as follows. 1. The mean insulin levels in cord vein blood of the healthy neonates (N=38) in late or term pregnancy (38-41 weeks) accounted for 6.9±0.7μu/ml, when based on the term gestational weeks of 38 to 41 (Table 1) or 7.3±0.7μu/ml in neonates with average mature weight (2500~3999 g). These were compaired with 13.2±4.2μu/ml of large neonates weighing 40009 or more (TabBle 2). 2. Although the results were not significant, the mean insulin content in cord blood showed tendency of a rise with advancing gestational weeks(5.8±0.3 μu/ml at 34-37 weeks vs. 6.9±0.7μu/ml at 38-41 weeks vs. 8.6±2.2μu/ml at 42-43weeks) (Table 1). 3. Insulin level in cord blood also revealed tendency of a rise with increasing percentiles of birth weight (6.7±1.9μu/ml of 10th or 6.8±0.7μu /ml of 50th vs. 9.2±2.1μu/ml of 90th percentile) (Table 3). In conclusion, the ranges of insulin level in fetal cord blood of healthy neonates in term or late pregnancy were proportionally constant according to the birth weight, and the insulin values showed that tendency of a rise with increasing birth weight.