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1、北京医学2009年第31卷第6期·337··论著·妊娠糖尿病患者血清脂联素水平及其临床意义131332111程飞郭晓蕙杨慧霞卢桂芝惠岩陈澜【摘要】目的探讨孕期脂联素水平变化与妊娠期糖尿病发病的关系。方法104例孕妇,根据75g葡萄糖耐量试验(OGTT)结果分为正常葡萄糖耐量妊娠组(NGT组)和妊娠期糖尿病组(GDM组)。用RIA方法测定血清脂联素浓度,同时测定血糖、血清胰岛素、血脂,并计算稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-B)和胰岛素敏感性指数(ISI),分析各指标与GDM的关系。结果GDM组脂联素水平低于NGT组,有显著
2、性差异(P<0.01);GDM组空腹血糖、空腹胰岛素、血脂水平、HOMA-IR均高于NGT组,而ISI、HOMA-B水平均低于NGT组,有显著性差异(P<0.05);血清脂联素水平与HOMA-IR、空腹血糖、空腹胰岛素、孕早期体质指数(BMI)及ISI呈显著性相关;Logistic回归分析显示:低脂联素血症、孕早期BMI、高胆固醇血症和糖尿病家族史是妊娠妇女发生妊娠期糖尿病的危险因素。结论GDM组孕妇脂联素水平显著下降;低脂联素血症不仅反映了母体肥胖和胰岛素抵抗状态,而且可能促进了孕期糖代谢损害的发生;低脂联素血症是预测妊娠糖尿病发病和转归的重要因素之一。【关
3、键词】妊娠期糖尿病脂联素危险因素胰岛素抵抗TheserumadiponectinchangesanditsroleinwomenwithgestationaldiabetesmellitusCHENGFei,GUOXiao-hui,YANGHui-xia,etal(DepartmentofEndocrinology,PekingUniversityFirstHospital,Beijing100034)【Abstract】ObjectiveToinvestigatetherelationbetweenthegestationaldiabetesmellitus
4、andthechangesofse2rumadiponectin.Methods104pregnantwomenwereselected.Accordingtotheresultsof75gOGTT,theyweredivid2edinto2groups:gestationaldiabetesmellitusgroup(GDM)andnormalglucosetolerancegroup(NGT).Theserumadi2ponectinweremeasuredbyusingRIA.Serumglucose,lipidandinsulinwerealsomea
5、suredonfastingsamples.ResultsThelevelofadiponectin,ISIandHOMA-BweresignificantlydecreasedinGDMgroupcomparedwiththatoftheNGTgroup.ThelevelsofFBG,Lipid,HOMA-IRweresignificantlyincreasedinGDMgroupcomparedwiththatoftheNGTgroup.CorrelationwasfoundbetweenthelevelofadiponectinwithHOMA-IR,F
6、BG,FIns,pre-BMIandISI.LogisticanalysisshowedthatGDMwassignificantlyrelatedwithhypoadiponectin,pre-BMI,cholesterolandfamilyhistoryofdia2betesmellitus.ConclusionsTheserumadiponectinlevelintheGDMgroupdecreasessignificantlythantheNGTgroup.DecreasedadiponectinconcentrationinGDMmaynotsimp
7、lyreflectmaternaladiposityandinsulinresistantstate,butmaycontributetotheimpairedglucosemetabolismduringpregnancy.Hypoadiponectinisoneofthemainriskfactorsinpre2dictingandscreeningofGDM.【Keywords】Gestationaldiabetesmellitus(GDM)AdiponectinRiskfactorsInsulinresistance(IR)妊娠期糖尿病(GDM)是指妊
8、娠期发生或首次诊的孕妇,通过对孕期不同
