关键词: 早产儿, 静脉营养, 血脂联素, 胆汁淤积

Abstract: Objective To investigate the association between serum adiponectin (APN) and parenteral nutrition-associated cholestasis (PNAC) in very low birth weight infant. Methods Fasting venous blood samples from preterm infants admitted to the First People's Hospital of Jining within 24~48 hours were collected to evaluate the serum levels of adiponectin.The preterm infants were divided into two groups:≥13.15 mg/L to high adiponectin group (n=63) and <13.15 mg/L to low adiponectin group (n=72),based on a median of 13.15 mg/L of adiponectin level.The incidence of PNAC was recorded in the next five weeks,and the occurrence of PNAC was used to determine the end point.Kaplan-Meier Methods were used to analyze the incidence of PNAC,while the correlation of serum adiponectin level and the incidence of PNAC was estimated with the use of univariate Cox regression analysis. Results The incidence of PNAC in low adiponectin group at 2,3,4 and 5 weeks were 21.8%,43.1%,64.0%,and 79.2%,respectively.There was a trend for a lower adiponectin concentrations which become significantly lower at 3 and 4 weeks (P<0.01).The incidence of PNAC in high adiponectin group at different weeks were respectively 17.9%,33.1%,49.3% and 67.8%,However,the serum levels of adiponectin were similar (P>0.05).There were statistically significant differences in the incidence of PNAC between two groups (P<0.01).Univariate Cox regression analysis indicated that adiponectin levels was an independent predictor of long-term outcome in the patients (P<0.05). Conclusions Decreased adiponectin concentrations might be attributed to the higher incidence of PNAC in low adiponectin group during follow up.Adiponectin is associated with PNAC in very low birth weight infants.

Key words: preterm infants, parenteral nutrition, serum adiponectin, cholestasis