CAJ | 학술논문

目的探讨胎盘胰岛素样生长因子1 (insulin-like growth factor 1,IGF-1)基因表达和甲基化变化与巨大儿发生的关系.方法选择2011年4月至2012年3月在温州医科大学附属育英儿童医院正常妊娠并足月分娩的129名产妇和新生儿为研究对象,其中59例为巨大儿、70名为正常体重儿.调查产妇和新生儿的基本信息,并收集胎盘样品.实时荧光定量PCR检测胎盘IGF-1 mRNA的表达量,MassARRAY系统测定胎盘IGF-1基因启动子区CpG位点的甲基化水平.结果与正常体重儿比较,巨大儿胎盘IGF-1表达量和胎盘IGF-1甲基化水平的差异无统计学意义(P值分别为0.967、0.925).胎盘mRNA表达量和IGF-1甲基化水平亦无统计学意义的相关性(r=0.128,P=0.295).巨大儿与正常体重儿胎盘启动子区的CpG位点均呈低甲基化状态.以所有出生体重的上四分位数间距(4260 g)为拐点,出生体重＜4260 g组的mRNA表达量显著高于≥4260 g组(t=2.806,P=0.005),且与出生体重呈正相关关系(r=0.264,P=0.022).表明在出生体重＜4260 g范围内,IGF-1表达量的增加贡献于出生体重的增长.但当胎儿过大时,存在负反馈调节作用,使表达量降低,以限制胎儿过度增大.结论胎盘IGF-1的表达量与出生体重呈双向性关联,其表达量的高低均与处于低甲基化状态的胎盘IGF-1的甲基化程度无关.
목적 탐토태반이도소양생장인자1 (insulin-like growth factor 1,IGF-1)기인표체화갑기화변화여거대인발생적관계.방법 선택2011년4월지2012년3월재온주의과대학부속육영인동의원정상임신병족월분면적129명산부화신생인위연구대상,기중59례위거대인、70명위정상체중인.조사산부화신생인적기본신식,병수집태반양품.실시형광정량PCR검측태반IGF-1 mRNA적표체량,MassARRAY계통측정태반IGF-1기인계동자구CpG위점적갑기화수평.결과 여정상체중인비교,거대인태반IGF-1표체량화태반IGF-1갑기화수평적차이무통계학의의(P치분별위0.967、0.925).태반mRNA표체량화IGF-1갑기화수평역무통계학의의적상관성(r=0.128,P=0.295).거대인여정상체중인태반계동자구적CpG위점균정저갑기화상태.이소유출생체중적상사분위수간거(4260 g)위괴점,출생체중＜4260 g조적mRNA표체량현저고우≥4260 g조(t=2.806,P=0.005),차여출생체중정정상관관계(r=0.264,P=0.022).표명재출생체중＜4260 g범위내,IGF-1표체량적증가공헌우출생체중적증장.단당태인과대시,존재부반궤조절작용,사표체량강저,이한제태인과도증대.결론 태반IGF-1적표체량여출생체중정쌍향성관련,기표체량적고저균여처우저갑기화상태적태반IGF-1적갑기화정도무관.
Objective To explore the correlation between methylation of insulin-like growth factor 1 (IGF-1)gene promoter and its placenta-specific expression and fetal macrosoma.Methods One hundred twenty nine healthy pregnant women were recruited between April 2011 and March 2012.Baseline data were collected with self-report questionnaires.Real-time quantitative PCR was used to determine the expression of IGF-1 mRNA in the placenta.Methylation level of the IGF-1 gene was determined with matrix-assisted laser desorption/ionization-time of flight mass spectrometry.Results The expression of IGF-1 in placenta and its methylation level showed no significant difference between macrosomic fetuses and controls.No linear correlation was found between IGF-1 mRNA expression and methylation level of IGF-1 promoter (r=0.128,P=0.295).IGF-1 promoter region in placenta showed a hypomethylation status.However,a positive correlation was found between IGF-1 expression and birth weight below 4260 g (r=0.264,P=0.022).The expression of IGF-1 mRNA was significantly higher in those with a birth weight below 4260 g,which suggested that placental IGF-1 expression may contribute to increased birth weight.In regard to fetal overgrowth,however,there seemed to be a negative correlation in which placental IGF-1 expression was downregulated to limit fetal overgrowth.Conclusion No linear correlation was found between placental IGF-1 expression and methylation level of IGF-1 promoter with a hypomethylation status.The contribution of placental IGF-1 expression to birth weight is bidirectional.Increased expression seems to promote fetal growth,while decreased expressions may curb overgrowth,therefore control fetal growth in a relatively normal range.