脂联素水平对妊娠期血糖代谢影响的临床观察
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摘要
目的探讨妊娠不同时期脂联素水平和妊娠期间血糖代谢的关系。方法选取2016年6月至2018年1月在河北省清河县人民医院产科门诊备孕和孕期管理的孕妇,依据妊娠期糖尿病(gestational diabetes mellitus, GDM)诊断标准筛查出的51例GDM患者作为GDM组,同期年龄相仿的血糖正常的51例孕妇作为NGDM组。分别于孕前、孕早期、孕中期采集血液标本检测TC、TG、LDL-C、HDL-C、空腹血糖(fasting plasma glucose, FPG)、空腹胰岛素(fasting serum insulin, FINS)、脂联素,进行对比分析。结果 NGDM组孕前和孕中期脂联素、FINS、稳态模型胰岛素抵抗指数(homeostatic model assessment-insulin resistance, HOMA-IR)相比,差异有统计学意义(P <0.05)。GDM组孕中期和孕前比较,孕中期和孕早期比较,脂联素、FINS、HOMA-IR差异均有统计学意义(P <0.05)。NGDM组和GDM组在孕前及孕早期各指标相比,差异无统计学意义(P> 0.05),孕中期脂联素和HOMA-IR相比,差异有统计学意义(P <0.05)。GDM组孕中期脂联素水平与FPG、FINS、HOMA-IR呈显著负相关(r=-0.813,r=-0.901,r=-0.866,P均<0.01)。结论脂联素水平和GDM的发生具有相关性。
Objective To investigate the relationship between adiponectin levels and glucose metabolism during pregnancy. Methods There were 51 patients with gestational diabetes mellitus(GDM) in GDM group, and 51 pregnant women with normal blood glucose in non-GDM(NGDM) group. Blood samples were collected in the pre-pregnancy period, the first trimester(6-12 weeks) and the second trimester(24-28 weeks) of pregnancy. TC, TG, LDL-C, HDL-C, fasting plama glucose(FPG), fasting insulin(FINS), and adiponectin were tested and compared. Results There were significant differences in adiponectin, FINS, and homeostatic model assessment-insulin resistance(HOMA-IR) between the first trimester and the second trimester of pregnancy(P < 0.05) in NGDM group. Compared between the first trimester and the second trimester of pregnancy, the pre-pregnancy period and the first trimester, the differences of adiponectin, FINS, and HOMA-IR were statistically significant(P < 0.05) in GDM group. Compared between GDM and NGDM group, there were no significant differences in the pre-pregnancy period and the first trimester of pregnancy(P > 0.05), while there were significant differences of adiponectin and HOMA-IR in the second trimester of pregnancy(P < 0.05). There were significant negative correlations between adiponectin level and FPG, FINS, HOMA-IR(r =-0.813, r =-0.901, r =-0.866, all P < 0.01) in the second trimester. Conclusions The level of adiponectin is correlated with GDM.
Objective To investigate the relationship between adiponectin levels and glucose metabolism during pregnancy. Methods There were 51 patients with gestational diabetes mellitus(GDM) in GDM group, and 51 pregnant women with normal blood glucose in non-GDM(NGDM) group. Blood samples were collected in the pre-pregnancy period, the first trimester(6-12 weeks) and the second trimester(24-28 weeks) of pregnancy. TC, TG, LDL-C, HDL-C, fasting plama glucose(FPG), fasting insulin(FINS), and adiponectin were tested and compared. Results There were significant differences in adiponectin, FINS, and homeostatic model assessment-insulin resistance(HOMA-IR) between the first trimester and the second trimester of pregnancy(P < 0.05) in NGDM group. Compared between the first trimester and the second trimester of pregnancy, the pre-pregnancy period and the first trimester, the differences of adiponectin, FINS, and HOMA-IR were statistically significant(P < 0.05) in GDM group. Compared between GDM and NGDM group, there were no significant differences in the pre-pregnancy period and the first trimester of pregnancy(P > 0.05), while there were significant differences of adiponectin and HOMA-IR in the second trimester of pregnancy(P < 0.05). There were significant negative correlations between adiponectin level and FPG, FINS, HOMA-IR(r =-0.813, r =-0.901, r =-0.866, all P < 0.01) in the second trimester. Conclusions The level of adiponectin is correlated with GDM.
引文
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[8]徐艳红,马丽娜,李耘.脂联素的心血管生物学功能研究进展[J].北京医学, 2017, 39:382-385.
[9] Greenhill C. Diabetes:the role of adiponectin in gestational diabetes mellitus[J]. Nat Rev Endocrinol, 2017, 13:128.
[10] Soheilykhah S, Mohammadi M, Mojibian M, et al. Maternal serum adiponectin concentration in gestational diabetes[J]. Gynecol Endocrinol,2009,25:593-596.
[11] Pala HG, Ozalp Y, Yener AS, et al. Adiponectin levels in gestational diabetes mellitus and in pregnant women without glucose intolerance[J]. Adv Clin Exp Med, 2015, 24:85-92.
[2]杨慧霞.妊娠合并糖尿病--临床实践指南[M]. 2版.北京:人民卫生出版社, 2013:371-377.
[3]黄诗韵,陈奕.妊娠期糖尿病并发重度子痫前期孕妇糖脂代谢水平及围产结局分析[J].北京医学, 2018, 40:845-849.
[4] Zhao E, Zhang Y, Zeng X, et al. Association between maternal diabetes mellitus and the risk of congenital malformations:a meta-analysis of cohort studies[J]. Drug Discov Ther, 2015, 9:274-281.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志, 2018, 38:292-344.
[6] Silha JV, Krsek M, Skrha JV, et al. Plasma resistin,adiponectin and lepein levels in lean and obese subjects:correlations with insulin resistance[J]. Eur J Endocrinol, 2013, 149:331-335.
[7] Yoda-Murakami M, Taniguchi M, Takahashi K, et al. Change in expression of GBP28/adiponectin in carbon tetrachloride-administrated mouse liver[J]. Biochem Biophys Res Commun, 2001, 285:372-377.
[8]徐艳红,马丽娜,李耘.脂联素的心血管生物学功能研究进展[J].北京医学, 2017, 39:382-385.
[9] Greenhill C. Diabetes:the role of adiponectin in gestational diabetes mellitus[J]. Nat Rev Endocrinol, 2017, 13:128.
[10] Soheilykhah S, Mohammadi M, Mojibian M, et al. Maternal serum adiponectin concentration in gestational diabetes[J]. Gynecol Endocrinol,2009,25:593-596.
[11] Pala HG, Ozalp Y, Yener AS, et al. Adiponectin levels in gestational diabetes mellitus and in pregnant women without glucose intolerance[J]. Adv Clin Exp Med, 2015, 24:85-92.