妊娠早期脂联素水平对妊娠期糖尿病的预测价值  

Value of adiponectin level in early pregnancy in predicting gestational diabetes mellitus

作　　者：刘菊菊[1] 田静[1] 

机构地区：[1]南京医科大学附属妇幼保健院产科,江苏省210004

出　　处：《江苏医药》2016年第6期658-660,共3页Jiangsu Medical Journal

摘　　要：目的探讨妊娠早期脂联素水平对妊娠期糖尿病（GDM）发病风险的预测价值。方法检测890例妊娠早期（6～13周）孕妇的血脂联素水平,至妊娠中期（24～28周）行75g口服葡萄糖耐量试验。根据结果分为GDM组（A组,76例）和糖耐量正常对照组（B组,814例）,分析妊娠早期脂联素水平与妊娠中期GDM发病风险及血糖调节相关指标之间的相关性。结果 A组妊娠早期和中期脂联素水平均低于B组[（9.67±3.84）μg/ml vs.（11.92±4.59）μg/ml和（9.70±5.18）μg/ml vs.（11.67±4.72）μg/ml]（P〈0.05）。调整年龄、BMI、体脂百分比、腰围等混杂因素后,妊娠早期脂联素低表达是妊娠中期GDM发病的危险因素[OR=1.14,95%CI（1.04～1.25）,P〈0.01]。妊娠早期和中期的脂联素水平与妊娠中期的胰岛素抵抗指数、总血糖或胰岛素曲线下面积均呈负相关（r=-0.22、-0.16和-0.22、-0.17,P〈0.01）,与妊娠中期的胰岛素敏感性指数、胰岛素分泌敏感性指数2均呈正相关（r=0.28、0.21和0.29、0.22,P〈0.01）。结论妊娠早期脂联素的水平对妊娠中期GDM发病具有较稳定的预测价值。Objective To investigate the value of adiponectin level in early pregnancy in predicting gestational diabetes mellitus（GDM）.Methods Plasma level of adiponectin was detected in 890 pregnant women in early pregnancy（6 to 13 gestation weeks）,who underwent 75 g oral glucose tolerance test in medium-term pregnancy（24 to 28 gestation weeks）.On the basis of glucose tolerance test results,the patients were assigned into two groups of A（with GDM,76 cases）and B（without GDM,814cases）.The correlation of adiponectin levels in early pregnancy with GDM in medium-term pregnancy and the indexes related to blood glucose regulation was analyzed.Results Plasma levels of adiponectin in early and medium-term pregnancy were lower in group A than those in group B[（9.67±3.84）μg/ml vs.（11.92±4.59）μg/ml and（9.70±5.18）μg/ml vs.（11.67±4.72）μg/ml]（P〈0.05）.Adjusted for age,BMI,body fat percentage,waistline and other confounding factors,the lower adiponectin expression in early pregnancy was a risk factor for GDM in medium-term pregnancy[OR=1.14,95%CI（1.04-1.25）,P〈0.01].Adiponectin levels in early and medium-term pregnancy were negatively correlated with HOMA-IR and AUC_（insulin/glucose）（r=-0.22,-0.16 and-0.22,-0.17,P〈0.01）,and were positively correlated with Matsuda index and ISSI-2（r=0.28,0.21 and 0.29,0.22,P〈0.01）.Conclusion Adiponectin level in early pregnancy has a stable prediction value of GDM in medium-term pregnancy.

关 键 词：脂联素 妊娠期糖尿病 

分 类 号：R714[医药卫生—妇产科学]