子痫前期患者孕中期血清脂联素水平及胰岛素抵抗的变化及意义  

Changes and significance of serum level ofadiponectin and insulin resistance in second trimester of pregnancy women with preeclampsia

作　　者：李健[1] 崔晓梅[1] 位菊峰[1] 孙萍[1] 于华[1] 张雪茹[1] 

机构地区：[1]山东省青岛大学医学院第二附属医院(青岛市中心医院)妇产科,山东青岛266042

出　　处：《中国优生与遗传杂志》2012年第9期58-60,共3页Chinese Journal of Birth Health & Heredity

基　　金：青岛市2009年度医药科研指导计划(2009-WSZD043)

摘　　要：目的测定子痫前期(preeclampsia,PE)孕妇孕中期血清脂联素及胰岛素抵抗的变化并探讨其意义。方法随机选择2009年7月至2010年7月在青岛大学医学院第二附属医院门诊检查的孕妇300名,进行前瞻性研究分析,根据妊娠结局,发展为子痫前期共31人纳入研究组(PE,n=31),同时选取30名正常孕妇作为对照组。于24～28孕周时,采用放射免疫吸附法测定血清脂联素(adiponectin,APN)、胰岛素(Fastig insulin,Fins),并测定空腹血糖(fasting blood sugar,FBG)及其他临床指标,稳定模型的胰岛素抵抗指数(homeostatic model assessment-insulin resistance,HOMA-IR)用(Fins×FBG)/22.5来表示。并进行相关分析。结果①子痫前期组孕妇平均动脉压(mean arterial blood pressure,MABP)与对照组比较明显升高,有统计学意义(P<0.01)。②研究组与对照组比较,血清脂联素水平明显降低,有统计学差异(P<0.01)。血清胰岛素及HOMA-IR明显升高,有统计学差异(P均<0.01)。FBG两组比较无统计学差异(P>0.05)。③研究组孕妇血清脂联素与胰岛素、HOMA-IR及MABP呈负相关(r=-0.87,r=-0.44,r=-0.51,P均<0.01),与BMI无相关关系(r=-0.26,P>0.05)。研究组孕妇HOMA-IR与胰岛素、MABP呈正相关(r=0.42,r=0.77,P均<0.01),与BMI无相关关系(r=-0.04,P>0.05)。结论孕中期低脂联素水平及高胰岛素抵抗与子痫前期的发生有关。Objective： To study the variation and clinical significance of adiponectin and insulin resistance in second trimester of pregnancy women with preeclampsia. Methods： A prospective observational study was carried out on 300 women who were admitted to our department from July 2009 to July 2010. They were divided into preeclampsia group （ PE group, n = 31 ） and control group （ normal group, n = 30） according to gestational outcomes. The levels of serum adiponectin and insulin were measured with radioimmunoas- say in 24 -28 gestational weeks. Fasting blood sugar （FBG） was also measured. Homeostatic model assessment - insulin resistance （ HOMA - IR） = （ Fins x FBG） /22. 5. The correlation of the levels of serum adiponectin, insulin, FBG and HOMA - IR were analyzed. Results： （1）Mean arterial blood pressure （MABP） was significantly higher in PE group compared with the control group （P 〈 0. 01 ）. （2） The adiponectin level was significantly lower in PE group compared with the control group （P 〈0. 01 ）. In the preeclamp- sia women insulin level and HOMA - IR were significantly increased than those in normai group （ P 〈 0. 01 ）. But no difference was found in FBG between the PE and control groups （ P 〉 0. 05 ）. （3）In PE group, negative correlation was shown between the levels adiponectin and insulin and HOMA - IR and MABP （r = -0. 87, r = -0. 44, r = -0. 51, P 〈0. 01 ） , no correlation was found between the levels adiponectin and body mass index （BMI） （ r = - 0. 26, P 〉 0. 05 ）. In PE group, positive correlation was shown between HOMA - IR and insulin and MABP （ r = 0.42, r = 0. 77, P 〈 0. O1 ）. No correlation was shown between HOMA - IR and BMI （ r = - 0. 04, P 〉 0. 05 ）. Conclusion ： The lower adiponectin and higher HOMA - IR in the second trimester of pregnancy may be related to the development of preeclampsia.

关 键 词：子痫前期 脂联素 胰岛素 胰岛素抵抗 

分 类 号：R714.2[医药卫生—妇产科学]