血清脂肪细胞因子与妊娠期糖尿病关系的研究  

Study on the relationship between serum adipocytokines and gestational diabetes mellitus

作　　者：温岩[1] 崔丽峰[1] 贾君容[1] 孙晓峰[2] 

机构地区：[1]吉林大学第一医院妇产科,吉林长春130021 [2]广州中医药大学第一附属医院产科

出　　处：《中国妇幼保健》2011年第25期3871-3872,共2页Maternal and Child Health Care of China

摘　　要：目的:探讨妊娠期糖尿病(GDM)孕妇血清脂肪因子脂联素、瘦素、肿瘤坏死因子(TNF-α)水平变化及其与胰岛素抵抗的相关性。方法:随机抽取孕周15～20周的孕妇测定空腹血糖(FBG)、空腹胰岛素(FINS)、血脂联素、瘦素、TNF-α水平,孕24～28周行OGTT检查,按结果分为3组,糖耐量正常组(NGT)59例,GDM组41例,GIGT组50例,比较各组胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HBCI)及孕前、孕中期的BMI的差异,分析血脂联素、瘦素、TNF-α与IR的关系。结果:①GDM组及GIGT组HOMA-IR较NGT组明显升高,差异有统计学意义(P<0.05),3组间HBCI比较差异无统计学意义(P>0.05)。②GDM组及GIGT组血清脂联素水平显著低于NGT组(P<0.05),血清瘦素水平及TNF-α水平则显著高于NGT组(P<0.05)。③脂联素与HOMA-IR呈负相关,相关系数为-0.65;而瘦素、TNF-α与HOMA-IR呈正相关,相关系数分别为0.58、0.47。结论:妊娠期糖尿病血清脂联素、瘦素、TNF-α水平的改变与妊娠期胰岛素抵抗有关,可作为GDM的重要预测因子。Objective： To explore the changes of serum adiponectin, leptin and tumor necrosis factor - a （ TNF - a） levels in women with gestational diabetes melfitus （GDM） and their association with insulin resistance. Methods： The pregnant women of 15 - 20 gestational weeks were selected randomly, their fasting blood glucose, fasting insulin, serum adiponeetin, leptin and TNF - a levels were detected, oral glucose tolerance test （OGTT） was carried out during 24 - 28 gestational weeks, then the pregnant women were divided into three groups according to the results： normal glucose tolerance （NGT） group （59 women） , GDM group （41 women） and gestational impaired glucose tolerance （GIGT） group （50 women） ; the differences of HOMA -IR and HBCI among different groups and the difference of BMI during the first and second trimester of pregnancy were compared ; the relationship between serum adiponectin, leptin, TNF - a and insulin resistance was analyzed. Results： HOMA - IR in GDM group and GIGT group were significantly higher than that in NGT group （ P 〈 0. 05 ） , there was no significant difference in HBCI among the three groups （ P 〉 0. 05 ） . The serum adiponectin levels in GDM group and GIGT group were significantly lower than that in NGT group （ P 〈 0. 05 ）, while the serum leptin and TNF - a levels in GDM group and GIGT group were significantly higher than those in NGT group （ P 〈 0. 05 ） . There was a negative correlation between adiponectin and HOMA - IR （y = -0. 65） ; leptin and TNF - a were positively correlated with HOMA - IR, respectively （y = 0. 58; y = 0.47） . Conclusion： The changes of serum adiponectin, leptin and TNF - a levels are related to insulin resistance in women with GDM. The factors can be used as important predictive factors of GDM.

关 键 词：妊娠期糖尿病 脂肪细胞因子 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]