Changes Of Serum Adiponectin And Insulin Like Growth Factor-1in Neonates With Hypoxic-Ischemic Encephalopathy And Their Clinical Significances

Background and Objective:Recently, with the development of molecular biology and molecular immunity, animal experiments and clinical researches have demonstrated that a lot of cytokine, chemokine and apoptosis promotion gene, apoptosis suppressor gene are involved in the course of HIE. APN, as a newly discovered inflammatory cytokine, whose role in HIE isn’t reported. IGF-1as a cytokine, plays an important role in HIE. But, the correlation between APN and IGF-1isn’t founded. The aim of our study is to detect the action of APN and IGF-1in HIE and probe into the co-relationship of them and the state of disease in order to provide a theory for treatment, such as APN and IGF-1.Method:This prospective case-control study, conducted in obstetrical department at Shandong Provincial Hospital Affiliated to Shandong University from June2012till April2013, to detect the serum level of IGF-1and adiponectin in52HIE newborns in cord blood,3to5days (acute period),10to14days (recovery period),20normal newborns were selected as control group. In our experiment, according to the diagnosis standard and clinical degree of HIE in the Subspecialty Group of Neonnatology, the HIE group included15severe,20moderate and17mild newborns. Infection diseases were eliminated in these cases.Results:(1) Serum level of adiponectin at cord blood and the acute period was significantly lower than those in controls different degree HIE (P<0.05); The adiponectin levels in mild, moderate and severe HIE newborns were different to each other (P<0.05); Adiponectin increased obvious at recovery period compared with those at acute, but moderate and severe were lower than control group (P＜0.05).(2) Serum level of IGF-1at cord blood and the acute period was significantly lower than those in controls different degree HIE (P<0.05); The IGF-1levels in mild, moderate and severe HIE newborns were different to each other (P<0.05); IGF-1increased obvious at recovery period compared with those at acute, but moderate and severe were lower than control group (P<0.05).(3) Serum level of IGF-1was positivity correlated with that of adiponectin at the acute period and umbilical cord blood of HIE newborns (r=0.531-. r=0.611)(P<0.01).Conclusion(1) The serum level of APN and IGF-1in HIE patients are lower obviously than non-HIE groups which shows that they participate in the pathophysiological process of neonate hypoxic ischemic encephalopathy.(2)There are close relation between the change of APN, IGF-1and the patient,s condition, course of disease. It is significant to supervise the trends of APN and IGF-1for judging the state of disease and estimating the prognosis.(3)During the same course of neonate hypoxic ischemic encephalopathy, there are positive correlation between APN and IGF-1in the same group. In acute period, they raised and reached their Lowest. Meanwhile, they descended in recovery period which indicate that APN and IGF-1are neuroprotective factor to brain cell.(4)It is simple, accurate, less blood and distinctive to test the level of APN and IGF-1in HIE patients with ELISA which has practical value in clinical work.