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Title: Circulating IGF-1 may mediate improvements in haemoglobin associated with vitamin A status during pregnancy in rural Nepalese women.
Author: Arguello MA, Schulze KJ, Wu LS, Dreyfuss ML, Khatry SK, Christian P, West KP.
Journal: Asia Pac J Clin Nutr; 2015; 24(1):128-37. PubMed ID: 25740751.
Abstract:
Pregnancy exacerbates vitamin A (VA) deficiency and anaemia among women in developing countries. Improving circulating haemoglobin (Hb) requires erythrocyte production and availability of iron. Insulin-like growth factor- 1 (IGF-1) functions in erythropoiesis, but its association with VA status and pregnancy-associated anaemia has not been studied. The aim of this study was to examine the relationship between serum retinol, IGF-1, and Hb among pregnant women in extant samples collected during a placebo-controlled trial of VA and beta-carotene (BC) supplementation in rural Nepal conducted from 1994 to 1997. Mid-pregnancy serum IGF-1 was measured in serum from n=589 randomly selected women of n=1186 in whom anthropometric, VA (retinol) and iron (Hb, erythrocyte zinc protoporphyrin (ZP), and ferritin) status data were available. Associations of IGF-1 with retinol, Hb or anaemia, and iron status were determined using multiple linear and logistic regression. Path analysis was used to explore the role of IGF-1 as a mediator between retinol and Hb, accounting for iron status. A 2.6 g/L increase in IGF-1 was observed per 0.1 mol/L increment in retinol (p<0.0001). Hb increased with each quartile of IGF-1, and odds of anaemia declined 68.8% from the 1st to 4th quartile. Improved iron status indicators explained only 29.1% of the association between IGF-1 and Hb, while IGF-1 explained 25.6% of the association between retinol and Hb. Increasing IGF-1 was likely one mechanism by which retinol improved circulating Hb in pregnant women of rural Nepal, although IGF-1 worked primarily through pathways independent of improved iron status indicators, perhaps by stimulating erythrocyte production. 怀孕加剧了发展中国家妇女维生素A 的缺乏和贫血。提高循环血红蛋白（Hb）需要红细胞的生成和可利用的铁。胰岛素样生长因子-1（IGF-1）在红细胞生成中发挥其功能，但是尚没有其与维生素A 状况和妊娠相关贫血之间关系的研究。本研究的目的是在1994 年到1997 年间在尼泊尔农村进行的补充维生素A 和β-胡萝卜素（BC）的安慰剂-对照试验现存的样本中，研究怀孕妇女血清视黄醇、IGF-1 和Hb 之间的关系。从1186 名有人体测量、维生素A （视黄醇）和铁（血红蛋白、红细胞锌原卟啉和铁蛋白）的资料的妇女中，随机测定589 名妊娠中期妇女的血清IGF-1。采用多重线性回归和logistic 回归来确定IGF-1 和视黄醇、Hb 或贫血与铁营养状况之间的关系。采用路径分析探讨IGF-1 作为视黄醇和Hb 之间介物的作用来评估铁营养状况。观察到视黄醇每增加0.1 mol/L，IGF-1 增加2.6 g/L（p<0.0001）。Hb 随着IGF-1 四分位的增加而增加，并且从第1 个四分位到第4 个四分位，贫血风险降低了 68.8%。铁营养状况改善的指标只能解释IGF-1 和Hb 之间关系的29.1%，而 IGF-1 能够解释视黄醇和Hb 之间关系的25.6%。虽然IGF-1 主要通过独立改善铁营养状态指标的途径发挥作用，增加的IGF-1 通过视黄醇改善尼泊尔农村怀孕妇女的循环Hb 也可能是机制之一，可能是通过刺激红细胞生成。

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