| ObjectiveTo explore the evolution-track of glucose and lipid metabolism in early life stages,the influence of maternal intrauterine environment to it and its pre-warning possibility for the metabolic syndrome occurring in childhood and whole life.Methods6162 pregnant women and their babies(among them 4417 babies were normal neonates)from 12 maternity centers in 4 provinces or cities all over China were enrolled in this prospective multicenter cohort study,whose eleven items about glucose and lipid metabolism were inspected in laboratoty.Meanwhile,the maternal and family’s factors relevant to intrauterine environment and metabolic syndrome were investigated by questionnaire survey.Then,the follow-up investigation were carried out about the growth and development of the children,the evolution-track of these experimental items about glucose and lipid metabolism from birth to 3 years old.On this basis,it was analysed about the variation of these 11 items in different stage of early life and their interrelation,the correlation among bad intrauterine environment,the future risk of metabolic syndrome and the level of glucose and lipid metabolism in early life stages.Results1.Accoding to the detection of 11 items about glucose and lipid metabolism in umbilical cord blood,the normal reference value of them in Chinese neonates were proposed,which in male neonates are:apolipoprotein A1(APOA1)0.81±0.17g/1,apolipoprotein B(APOB)0.20±0.12g/l,high-density lipoprotein cholesterol(HDL-CH)0.71±0.31mmol/l,low-density lipoprotein cholesterol(LDL-CH)0.72 ± 0.43mmol/l,lipoprotein a(LPa)0.03±0.04g/l,total cholesterol(TC)1.69±0.57 mmol/1,triglyceride(TG)0.35±0.31 mmol/l)C peptide(0.31±0.19mmol/l),Hemoglobin A1C(HbA1c)3.29± 2.1%,Insulin(Ins)7.16±7.15mu/l,fasting blood-glucose(FPG)3.18±1.55 mmol/1;in female neonates are:APOA10.85±0.17g/l,APOB 0.2±0.11g/1,HDL-CH 0.76 ± 0.33mmol/l,LDL-CH 0.73±0.3 mmol/l,LPa 0.03±0.03 g/l,TC 1.76±0.58mmol/l,TG 0.35±0.31 mmol/l,C peptide 0.33±0.2 mmol/l,HbAlc 3.26±1.39%,Ins 7.617.13mu/l,FPG 3.08±1.49 mmol/1.2.The blood levels of LPa,C peptide,Insulin,APOB,LDL-CH,TC and LDLC/HDLC ratio are different between 1745 cases of abnormal neonates and 4417 normal neonates(P<0.05).3.The items relevant to lipid metabolism in late pregnant period are mostly(except of LDLC)higher than the normal reference value in common female adults,while the levels of C peptide and Insulin in late pregnant period are lower than the normal reference value.4.All of the levels of these items of umbilical cord blood are lower than the corresponding items in maternal blood samples taken during the late pregnancy.However,there are significant positive linear correlation existing between them.5.The levels of these items in early life stages are universally lower than the adult normal reference values and the late-pregnant maternal levels.Most of them(except of Insulin)increase along with the age growth.6.The maternal intrauterine environment are relative with the parameters of lipid metabolism and insulin in neonate blood as well as the levels of APOA1,LDLC,LDLC/HDLC ratio and total cholesterol in 18-month-old or 3-year-old children.The late-pregnant maternal levels of lipid-metabolism-parameters seemed to have impact on the intrauterine environment.Among them,HDLC and LDLC/HDLC ratio are the protective factors,whereas total cholesterol is the risk factor for intrauterine environment.7.A part of glucose-lipid metabolism parameters in early life stages maybe play a pre-warning role to the risk of metabolic syndrome in childhood or even in adulthood.The descent of serum HDLC,and APOA1 or the ascent of APOB/APOA1 ratio,LDLC/HDLC ratio,LPa and C peptide in early life + overweight or central obesity are the most probable pre-warning indications for future metabolic syndrome.ConclusionThe blood levels of the items relevant to glucose-lipid metabolism in early life stages are lower than the adult normal reference values,which increase along with the age growth.The intrauterine environment seemed to be influenced by late pregnant maternal lipid level,which maybe impact on a part of parameters of lipid and glucose metabolism in early life stages.A part of glucose-lipid metabolism parameters in early life stages maybe play a pre-warning role to the risk of metabolic syndrome. |
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