| BackgroundFetal growth is not only closely related to the post-natal status, but also plays a role in the development of metabolic syndrome in adulthood according to the recently proposed theory of "fetal programming", which has been demonstrated by epidemiological studies. So it will be of profound significance clarifying the mechanisms underlying fetal growth and factors involved in it. Unfortunately, little has been known about the mechanisms and relevant factors.Adiponectin is an adipocyte-derived hormone that has been discovered in the mid-1990s. It has drawn many researchers’ attentions since it was discovered for its profound insulin-sensitizing, anti-inflammatory, and anti-atherogenic effects. Apart from its obvious potential as a mediator of adult metabolic syndrome, adiponectin may take part in intrauterine fetal development. Recent studies have revealed a20-fold rise of adiponectin concentrations in fetal circulation from24weeks gestation to term and adiponectin concentration is substantially higher in cord blood than in maternal serum, which implies adiponectin may play an important role in regulating fetal growth.Previous studies have been focused on the relationship between cord blood adiponectin levels and neonatal anthropometric variables, but the results are controversial. While some researchers found that cord blood adiponectin levels were positively related to birth weight and birth length, others failed to obtain a relationship between cord blood adiponectin concentrations and neonatal anthropometric variables. Moreover, a few researchers even found neonatal adiponectin levels negatively correlate with fetal birth weight. Hence, data concerning the regulation of adiponectin in fetal growth process are yet to be clarified.What is important to note is that adiponectin expression seems to be regulated by dietary intakes, which is proposed by recent researches and our former studies. Interestingly, latest data from Jones HN, etal. indicate that full-length adiponectin regulates placental insulin signaling and amino acid transport, which implies adiponectin may have important implications for placental nutrient transport and fetal growth in pregnancies associated with altered maternal adiponectin levels. Thus, it can be speculated that adiponectin and maternal nutritional status may interact with each other rather than act alone in the progress of fetal growth. And it would be inadequate to analyse the effect of adiponectin in fetal growth in isolation since the important role of maternal nutritional status in fetal growth progress has been confirmed. Thus, researches revealing the correlations between maternal nutritional status and adiponectin levels, as well as the influence of adiponectin levels on fetal growth after adjustments of maternal nutritional status would be of great importance, but no relevant report has been found up to now.The present study is aimed at exploring the correlations between maternal nutritional status and adiponectin levels, as well as the influence of adiponectin levels on fetal growth after adjusted for maternal nutritional status. Our results would provide reference for regulating adiponectin levels through dietary management, thus to benefit fetal growth and achieve better pregnancy outcomes.Objective1Investigate the correlations between maternal nutritional status and adipo-nectin levels;2Exploring the influence of adiponectin levels on fetal growth after adjusted for possible confounding factors, which include maternal nutritional status, find out the appropriate nutritional status and adiponectin level that are conducive to the intrauterine fetal growth, and provide reference for improving maternal nutritional status and regulating adiponectin levels for an ideal pregnancy outcome through dietary management.MethodsWe recruited533pregnant women who have created a profile and intend to give birth at maternity and child care hospital in Yuexiu district or Baiyun district of Guangzhou city. Maternal and fetal basic informations and anthropometric measure-ments were collected by questionnaire designed by ourselves, and maternal dietary intakes were ascertained with a24-h dietary recall record for3consecutive days and analyzed by a nutrient evaluation software; maternal venous blood sample and cord blood were collected for the detection of adiponectin, triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein and glucose. We finally acquired469available questionnaires,426maternal serum samples and412cord serum sample, which include413maternal serum samples and334cord serum samples which are haemolysis-free and available for the detection. Datas were input through EpiData3.1, and analysed by SPSS13.0.Results1Maternal average intakes of cereal, meat, poultry and aquatic products reach the recommendation of the Chinese balanced diet guideline, the intakes of vegetables, fruits and eggs are slightly below the recommendation of the guideline, while the intakes of beans, milk and dairy are far below the recommendation of the guideline. Maternal average intakes of energy, protein, fat, carbohydrates, zinc, vitamin A, vitamin E and thiamine basically achieve recommended nutrient intake (RNI) or adequate intake (AI) established by The Chinese Nutrition Society, while the intakes of calcium, iron and riboflavin are lower than80%RNI/AI.2Adiponectin concentrations of maternal serum ranges from0.36ug/ml to32.4ug/ml, and the average is7.84±4.55ug/ml; Adiponectin concentrations of cord serum are much higher than that of maternal serum, range from4.00ug/ml to97.00ug/ml, average at40.54±16.31ug/ml.3Maternal and cord blood adiponectin levels are influenced by the maternal aquatic products intake, subjects whose aquatic products intake was in coincidence with the Chinese balanced diet guideline during the third trimesters have a significant higher maternal adiponectin level (F=3.757, P<0.05) as well as a higher cord blood adiponectin level (F=3.154, P=0.044) compared with subjects whose aquatic products intake was lower than recommended intake of the Chinese balanced diet guideline; the maternal intakes of soybean protein, fiber, vitamin E during the third trimesters is positively related with maternal serum adiponectin level (soybean protein vs. maternal serum APN:r=0.148, P=0.003; fiber vs. maternal serum APN:r=0.124, P=0.013; vitamin E vs. maternal serum APN:r=0.113, P=0.023), and the maternal intakes of vitamin E, iron, niacin during the third trimesters is positively related with cord serum adiponectin level (vitamin E vs. cord serum APN:r=0.159, P=0.004; iron vs cord serum APN:r=0.119, P=0.030; niacin vs cord serum APN:r=0.115, P=0.036)4Cord blood adiponectin levels are positively related to birthweight (r=0.231, P<0.001) and birthlength (r=0.177, P=0.001); multiple linear regression analysis reveal that cord blood adiponectin levels are still positively related with fetal birthweight (β=0.161, P=0.001) and birthlength (β=0.143, P=0.007) after adjustments of possible confounding factors, including maternal nutritional status; cord blood adiponectin levels interact with maternal intakes of energy and carbohydrates and have a combined influence on fetal growth, with the same maternal intake of energy or carbohydrates, subjects who has a higher cord blood adiponectin level present a higher birthlength (P<0.01)Conclusion1Maternal intakes of aquatic products, soybean protein, fiber and vitamin E during late pregnancy are positively correlate to maternal serum adiponectin levels, and intakes of aquatic products, vitamin E, iron and niacin are positively correlate to cord serum adiponectin.2Cord serum adiponectin levels is positively related to fetal birth weight and birth length. After adjusted for possible confounding factors, which included maternal nutritional factors, cord serum adiponectin levels is still positively related to fetal birth weight and birth length. Cord blood adiponectin levels have a combined influence on fetal growth, cord blood adiponectin levels interact with maternal energy and carbohydrates intakes and impact on birthlength.3It can be expected that we regulate maternal and fetal adiponectin levels through managements of dietary during pregnancy, thus to promote the intrauterine fetal growth and achieve better pregnancy outcomes. |
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