妊娠糖尿病患者脂联素水平及其与胰岛素抵抗的关系  

Association of adiponectin with insulin resistance in patients with gestational diabetes mellitus

作　　者：宋爱羚[1] 聂敏[1] 王瑛[1] 阴津华[1] 徐璐[1] 黎明[1] 

机构地区：[1]中国医学科学院,北京协和医院内分泌科,北京100730

出　　处：《生殖医学杂志》2012年第3期218-221,共4页Journal of Reproductive Medicine

基　　金：北京协和医院卫生部重点实验室及青年基金(2009013);北京市科技计划重点项目(D111100000611001)

摘　　要：目的探讨妊娠糖尿病(GDM)患者血清脂联素水平的变化及其与胰岛素抵抗之间的关系。方法 2010年4月至2011年3月,北京协和医院产科门诊行产前检查的妊娠24～28周孕妇,选取妊娠糖尿病患者和正常糖耐量(NGT)孕妇各77例,测定糖化血红蛋白(HbA1c)和血脂等,酶联免疫吸附法测定血浆脂联素及真胰岛素(TINS)水平,稳态模型胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗程度。采用单因素相关分析和多因素直线回归分析评价妊娠糖尿病患者血清中脂联素水平和胰岛素抵抗的关系。结果 (1)GDM组脂联素水平[10.83(8.47±12.71)mg/L]显著低于NGT组[23.29(17.92±27.90)mg/L](P<0.001);(2)脂联素与孕前体重指数(pre-BMI)、收缩压、舒张压、空腹血糖(FPG)、空腹胰岛素(FINS)、HbA1c、HOMA-IR和甘油三酯具有相关性(r值分别为-0.179、-0.197、-0.200、-0.372、-0.251、-0.198、0.305、-0.252,均P<0.05);(3)多因素直线回归分析显示:在控制pre-BMI、血脂和血压等因素后,脂联素下降(β=-1.037)是HOMA-IR独立危险因素(P<0.05)。结论 GDM患者血清脂联素水平降低与胰岛素抵抗程度独立相关,提示脂联素分泌紊乱可能参与了GDM患者胰岛素抵抗的病理生理机制。Objective： To evaluate the relationship between gestational diabetes mellitus （GDM）. adiponectin and insulin resistance in patients with Methods. There were 77 patients who were diagnosed with GDM at 24-28 weeks of pregnancy in maternity clinic of Peking Union Medical College Hospital from April 2010 to March 2011, and 77 healthy volunteers enrolled in the study. Serum levels of HbAlc, lipids, fasting blood glucose, fasting insulin and adiponectin were measured, and homeostasis model insulin resistance index （HOMA-IR） was calculated. Multivariate linear regression analysis was used to evaluate the association of adiponectin with insulin resistance in the patients diagnosed with GDM. Results. （1） The serum adiponectin levels in the GDM group were significantly lower than those in control [-10.83（8. 47±12.71） mg/L vs. 23.29（17.92±27.90） rag/L, P（0. 001-]. （2） The adiponectin levels were .significantly correlated with pre-pregnancv body mass indet （pre-BMI）,systolic blood. Conclusions： The decrease in adiponectin levels might play a role in pathophysiology of insulin resistance in GDM patients.

关 键 词：妊娠糖尿病 脂联素 胰岛素抵抗 

分 类 号：R[医药卫生]