بررسی ارتباط سطح سرمی ویسفاتین با شاخص‌های آنتروپومتریک و میزان وزنگیری دوران بارداری مادر

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، گروه بهداشت باروری و مامایی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران. مربی مامایی، دانشکده علوم پزشکی اسفراین، اسفراین، ایران

2 استادیار گروه مامایی و بهداشت باروری، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران.

3 کارشناس ارشد مامایی، گروه بهداشت باروری و مامایی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران.

چکیده

مقدمه: ویسفاتین یک آدیپوکین­ مترشحه از بافت چربی است که به ‌نظر می­رسد با میزان وزن­گیری در دوران بارداری مرتبط باشد، لذا مطالعه حاضر با هدف بررسی سطح سرمی ویسفاتین در بارداری و ارتباط آن با شاخص­های آنتروپومتریک و وزن­گیری دوران بارداری مادر انجام شد.
روش­کار: این مطالعه کوهورت در بازه زمانی آذر ماه سال 1394 تا شهریور سال 1395 بر روی 56 زن باردار 40-18 ساله در سه ماهه­ اول بارداری که برای مراقبت‌های دوران بارداری به مراکز جامع سلامت پرجمعیت مراجعه کرده بودند، انجام شد. زنان باردار از نظر شاخص توده بدنی قبل از بارداری به دو گروه A (BMI طبیعی) و B (BMI بالاتر از طبیعی) تقسیم­بندی و همگن شدند. سطح سرمی ویسفاتین در هفته‌های 12-6 و 20-15 بارداری به روش ELISA سنجش شد. روش گردآوری اطلاعات شامل: مشاهده، معاینه و مصاحبه بیمار با استفاده از پرسشنامه در سه بخش اطلاعات فردی، تاریخچه مامایی و طبی مادری و متغیرهای جنینی، نتایج آزمایشگاهی بود. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS و آزمون­های کای دو نمونه­ای، من‌ویتنی، آزمون رتبه علامت‌دار ویلکاکسون، رگرسیون و آزمون همبستگی رتبه­ای اسپیرمن انجام شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته­ها: میانگین ویسفاتین سرمی از سه ماهه اول بارداری به سه ماهه دوم بارداری در هر دو گروه به‌طور معنی­داری افزایش پیدا کرده بود (به‌ترتیب 005/0=pa و 001/0= pbدر گروه Aو B). میانگین سطح سرمی ویسفاتین سه ماهه دوم بارداری گروه B نسبت به گروه A به‌طور معناداری بیشتر بود (04/0=p). میزان وزن­گیری در طی سه ماهه دوم بارداری گروه A به‌طور معناداری در مقایسه با گروه B بیشتر بود (03/0=p). سطح ویسفاتین سه ماهه دوم ارتباط مثبت و معناداری با شاخص توده بدنی سه ماهه سوم بارداری در گروه A داشت (01/0=p، 54/0=r).
نتیجه­گیری: الگوی افزایشی در غلظت ویسفاتین پلاسمای مادر با پیشرفت بارداری در زنان باردار در گروه با شاخص توده بدنی طبیعی ممکن است تابعی از تغییرات افزایشی در بافت چربی احشایی باشد که در افزایش انعطاف­پذیری متابولیسم مادران در بارداری و کاهش بروز بیماری­های متابولیک نقش داشته باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Relationship between Serum visfatin with anthropometric indices and maternal gestational weight gain

نویسندگان [English]

  • Ashraf Saber 1
  • Najmeh Tehranian 2
  • Matin Sadat Esmailzade 3
  • Shiva Pourali Roudbaneh 3
1 M.Sc. in Midwifery, Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Instructor, Department of Midwifery, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
2 Assistant Professor, Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
3 M.Sc. in Midwifery, Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
چکیده [English]

Introduction: Visfatin is an Adipokine secreted from adipose tissue that seems to be related to weight gain during pregnancy. Therefore, this study was performed with aim to determine the relationship between serum visfatin levels in pregnancy with anthropometric indices and maternal gestational weight gain.
Methods: This cohort study was conducted on 56 pregnant women aged 18-40 years at first trimester of pregnancy who had referred to populous health comprehensive centers for prenatal care from December 2015 to September 2016. Pregnant women were divided in terms of BMI before pregnancy to two groups: A (normal BMI) and B (BMI higher than normal). Serum visfatin level was measured in gestational age of 6-12 and 15-20 weeks by ELISA method. Data collection method included observation, examination and interview with patient using the questionnaire in three parts: personal information, maternal medical and obstetric history, and fetal variables, laboratory results. Data was analyzed by SPSS software and Chi-square, Mann-Whitney, Wilcoxon Signed Rank Test, Regression and Spearman ranking correlation tests. P<0.05 was considered statistically significant.
Results: Mean serum visfatin significantly increased from first to second trimesters in both groups (Pa=0.005, Pb=0.001 in A and B groups, respectively). Mean serum visfatin levels at second trimester was significantly higher in B group than A group (p=0.04). Maternal weight gain during second trimester of pregnancy was significantly higher in A group compared with B group (p=0.03). In group A, second trimester visfatin levels had positive and significant relationship with third trimester BMI (p=0.01, r= 0.54).
Conclusion: An incremental pattern of maternal plasma visfatin concentration with pregnancy progression in pregnant women with normal BMI may be a function of incremental changes in visceral adipose tissue, which contributes to increased flexibility of maternal metabolism in pregnancy and reduced incidence of metabolic diseases.

کلیدواژه‌ها [English]

  • Visfatin
  • weight gain during pregnancy
  • anthropometric indices
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