孕妇血清瘦素水平测定对妊娠期糖耐量异常的预测价值  

Clinical study of maternal serum leptin levels as a predictor of gestational diabetes mellitus and gestational impaired glucose tolerance

作　　者：陈正琼[1] 成娅[1] 苏红媛[1] 谢荣凯[1] 林桂兰[1] 王智[1] 陈波洁[1] 

机构地区：[1]第三军医大学附属新桥医院妇产科,重庆400037

出　　处：《中华妇产科杂志》2005年第3期164-167,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨孕妇血清瘦素水平测定对妊娠期糖耐量异常有无预测价值.方法采用葡萄糖负荷试验法对583例孕妇行妊娠期糖尿病筛查,根据筛查结果分为糖耐量正常组及糖耐量异常组(包括妊娠期糖耐量低减和妊娠期糖尿病)孕妇.同时检测两组孕妇不同孕周的血清瘦素水平.结果 (1) 糖耐量正常组507例孕妇血清瘦素水平由孕24周的(7.0±1.8)μg/L逐渐缓慢上升,至孕34～35周时上升最为明显,形成峰值为(9.4±2.1)μg/L,之后略有下降.(2)糖耐量异常组76例(妊娠期糖耐量低减61例、妊娠期糖尿病15例)孕妇血清瘦素水平波动在(11.3±3.1)μg/L至(14.5±4.3)μg/L之间,不同孕周间的血清瘦素水平比较,差异无统计学意义(P>0.05).(3) 糖耐量异常组孕妇平均血清瘦素水平为(12.5±3.5)μg/L,显著高于糖耐量正常组的(8.5±2.6 )μg/L,且在任何孕周,糖耐量异常组孕妇血清瘦素水平均比糖耐量正常组显著升高,两组比较,差异有统计学意义(P<0.05). (4) 15例妊娠期糖尿病孕妇中,有10例血清瘦素水平超过14.0μg/L.当瘦素水平≥17.0μg/L时,64.7%的孕妇有不同程度的糖耐量异常.瘦素水平与妊娠期糖耐量低减和妊娠期糖尿病的患病率呈正相关.结论血清瘦素水平与妊娠期糖耐量异常有相关性, 血清瘦素水平升高对妊娠期糖耐量异常有预测价值.Objective To investigate whether maternal serum leptin level can be used as a predictor of gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT). Methods Five hundred and eighty-three pregnant women were screened for GDM by the 50g oral glucose challenge test. At the same time, serum leptin levels were determined by radioimmunoassay, then the relationship between maternal serum leptin level and the incidence of GIGT and GDM was analyzed. According to the screening result, all the pregnant women were divided into three groups, the normal glucose group (NGT group), the gestational impaired glucose tolerance group (GIGT group), and gestational diabetes mellitus group (GDM group). GIGT group and GDM group were named as glucose intolerant group as a whole. Results (1) The serum leptin concentration of normal pregnant women ascended gradually from (7.0±1.8)μg/L in 24 gestational week to (9.4±2.1) μg/L during 34-36 gestational week, and then declined slightly but still maintained high level till delivery. (2) The serum leptin concentration of the glucose intolerant pregnant women ranged from (11.3±3.1 )μg/L to(14.5±4.3)μg/L, and showed no difference among different gestational weeks (P>0.05). (3) Serum leptin level of glucose intolerant women was(12.5±3.5)μg/L on average, much higher than that of NGT group, (8.5±2.6 )μg/L (P<0.05), and this difference remained in any gestational week (P<0.05). (4) Most of the GDM clustered in the higher leptin level groups and 66.7% GDM had a serum leptin level higher than 14.0 μg/L. Moreover, 64.7% of women whose serum leptin level was above 17.0 μg/L had different degree of glucose intolerance. Serum leptin level positively correlated with the incidence of GIGT and GDM. Conclusion Serum leptin level is correlated with glucose tolerance during pregnancy. Its abnormal increase during pregnancy might have a predictive value for GDM and GIGT.

关 键 词：糖耐量异常 瘦素水平 孕妇血清 血清瘦素 糖耐量正常 妊娠期糖尿病 预测价值 孕周 葡萄糖 

分 类 号：R714.25[医药卫生—妇产科学]