妊娠糖尿病患者血清脂联素水平及其临床意义  

The serum adiponectin changes and its role in women with gestational diabetes mellitus

作　　者：程飞[1,2] 郭晓蕙[1] 杨慧霞[3] 卢桂芝[1] 惠岩[1] 陈澜[1] 

机构地区：[1]北京大学第一医院内分泌科,100034 [2]北京世纪坛医院内分泌科 [3]北京大学第一医院妇产科,100034

出　　处：《北京医学》2009年第6期337-339,共3页Beijing Medical Journal

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。Objective To investigate the relation between the gestational diabetes mellitus and the changes of serum adiponectin. Methods 104 pregnant women were selected. According to the results of 75g OGTF, they were divided into 2 groups： gestational diabetes mellitus group （GDM） and normal glucose tolerance group（NGT）. The serum adi- ponectin were measured by using RIA. Serum glucose,lipid and insulin were also measured on fasting samples. Results The level of adiponectin,ISI and HOMA - B were significantly decreased in GDM group compared with that of the NGT group. The levels of FBG, Lipid, HOMA - IR were significantly increased in GDM group compared with that of the NGT group. Correlation was found between the level of adiponectin with HOMA - IR, FBG, Fins, pre - BMI and ISI. Logistic analysis showed that GDM was significantly related with hypoadiponectin, pre - BMI, cholesterol and family history of dia- betes mellitus. Conclusions The serum adiponectin level in the GDM group decreases significantly than the NGT group. Decreased adiponectin concentration in GDM may not simply reflect maternal adiposity and insulin resistant state, but may contribute to the impaired glucose metabolism during pregnancy. Hypoadiponectin is one of the main risk factors in predicting and screening of GDM.

关 键 词：妊娠期糖尿病 脂联素 危险因素 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌] R714.2[医药卫生—内科学]