瘦素、脂联素、抵抗素、内肥素与妊娠糖尿病胰岛素抵抗的相关性研究  

Relationship of leptin,adiponectin,resistin,visfatin and insulin resistance in gestational diabetes mellitus

作　　者：贾忠兰[1] 卢新[1] 王雅杰[2] 郭艳玲[1] 方芳[2] 康熙雄[2] 

机构地区：[1]北京市海淀区妇幼保健院检验科,北京100080 [2]首都医科大学附属北京天坛医院,北京100050

出　　处：《中国免疫学杂志》2008年第12期1133-1135,1137,共4页Chinese Journal of Immunology

摘　　要：目的:探讨脂肪因子瘦素、脂联素、抵抗素、内肥素与妊娠糖尿病(GDM)胰岛素抵抗的相关性。方法:实验分为正常育龄妇女组(44例)、正常妊娠妇女组(62例)和妊娠糖尿病患者组(63例),用ELISA方法分别检测3组瘦素(Leptin),脂联素(Adiponectin),抵抗素(Resistin),内肥素(Visfatin)的水平,用葡萄糖氧化酶法检测血糖水平,免疫发光法检测胰岛素水平,用HOMA-IR(稳态模型胰岛素抵抗指数)表示胰岛素抵抗状态,HOMA-IR=空腹血糖×空腹血胰岛素÷22.5,用SPSS11.5统计软件进行统计分析。结果:妊娠糖尿病患者组的瘦素水平明显高于正常妊娠妇女组[(13.50±7.14)ng/ml、(7.78±3.82)ng/ml,P<0.001],正常妊娠妇女组明显高于正常育龄妇女组[(7.78±3.82)ng/ml、(1.73±0.70)ng/ml,P<0.001]差异具有统计学意义;GDM组的内肥素水平明显低于正常妊娠妇女组[(15.67±5.78)ng/ml、(22.43±5.68)ng/ml,P<0.001],正常妊娠妇女组明显低于正常育龄妇女组[(22.43±5.68)ng/ml、(36.46±13.34)ng/ml,P<0.001],差异具有统计学意义;GDM组的脂联素水平低于正常妊娠妇女组[(5491.71±2986.00)ng/ml、(6692.34±2583.51)ng/ml,P=0.029],差异有统计学意义,正常妊娠妇女组明显低于正常育龄妇女组[(6692.34±2583.51)ng/ml、(11076.82±3694.75)ng/ml,P<0.001],差异具有统计学意义;GDM组抵抗素水平与正常妊娠妇女组比较差异没有统计学意义。在妊娠糖尿病患者组,HOMA-IR与瘦素(r=0.352,P=0.005)正相关,与内肥素(r=-0.255,P=0.046)呈负相关。结论:妊娠糖尿病患者瘦素水平升高,内肥素和脂联素水平降低,瘦素和内肥素与胰岛素抵抗有关,瘦素和内肥素参与了妊娠糖尿病胰岛素抵抗的发生发展;脂联素和抵抗素与胰岛素抵抗不具有相关性,脂联素和抵抗素可能与妊娠糖尿病胰岛素抵抗的发生无关。Objective：To investigated the correlation between adipocytokines of leptin,adiponectin,resistin,visfatin and insulin resistance in gestational diabetes mellitus.Methods：Using 3-hour VPG-measured 75 g-OGTT for GDM diagnosis,63 pregnant women with GDM and 62 age-matched unaffected pregnant women were recruited,44 age-matched non-pregnant women without diabetes mellitus as the cortrol.Plasma leptin,adiponectin,resistin,visfatin levels were analyzed with enzyme-linked immunosorbent assay.Results：Plasma leptin level was significantly higher in GDM comparing with that of the unaffected pregnant women（13.50±7.14 ng/ml vs 7.78±3.82 ng/ml,P〈0.001）.Plasma leptin level in unaffected pregnant women was significantly higher than normal non-pregnant women（7.78±3.82 ng/ml vs 1.73±0.70 ng/ml,P〈0.001）.Plasma visfatin level was significantly lower in GDM than in the unaffected pregnant women（15.67±5.78 ng/ml vs 22.43±5.68 ng/ml,P〈0.001）,and plasma visfatin level in unaffected pregnant women was significantly lower than normal non-pregnant women（22.43±5.68 ng/ml vs 36.46±13.34 ng/ml,P〈0.001）.Plasma adiponectin level was significantly lower in GDM compared with unaffected pregnant women（5 491.71±2 986.00 ng/ml vs 6 692.34±2 583.51 ng/ml,P=0.029）.Plasma adiponectin level in unaffected pregnant women was significantly lower than in the normal non-pregnant women（6 692.34±2 583.51 ng/ml vs 1 1076.82±3 694.75 ng/ml,P〈0.001）.Plasma resistin level was not significantly difference in GDM comparing with unaffected pregnant women（13.63±3.97 ng/ml vs 12.52±3.40 ng/ml,P=0.081）,but significantly difference occurred in unaffected pregnant women and normal non-pregnant women（12.52±3.40 ng/ml vs 9.64±3.02 ng/ml,P〈0.001）.In GDM group,HOMA-IR was correlated positively with concentrations of leptin（r=0.352,P=0.005）and negatively correlated with those of visfatin（r=-0.255,P=0.046）.Conclusion：Normol pregnant women are exhibited physiological insulin resistance,whereas in GDM exi

关 键 词：妊娠 糖尿病 脂肪细胞因子 胰岛素抵抗 

分 类 号：R714.25[医药卫生—妇产科学]