妊娠期糖尿病(A1及A2级)的高危因素及Chemerin、RBP4指标的研究  

High risk factors and detection indexes of Chemerin and RBP4 of gestational diabetes mellitus(A1 and A2)

作　　者：杜习羽[1] 董玉楠[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院,广东深圳518000

出　　处：《中国妇幼健康研究》2017年第1期66-68,共3页Chinese Journal of Woman and Child Health Research

基　　金：深圳市科技创新委员会知识创新计划基础研究项目(项目编号:JCYJ20130402094702483)

摘　　要：目的探讨不同严重程度的妊娠期糖尿病(GDM)的相关高危因素及检测指标。方法检测GDM孕妇及正常孕妇孕中期的Chemerin、RBP4及血清胰岛素水平,并跟踪至孕晚期。将GDM患者共218例分为GDM Al组(仅需饮食控制血糖)和GDM A2组(需胰岛素控制血糖),44例正常妊娠孕妇作为对照组。分析3组孕妇年龄、孕期BMI值、Chemerin、RBP4、胰岛素水平、葡萄糖耐量试验(OGTT)数值等因素及指标。结果 GDM A1组和GDM A2组的孕妇年龄、孕前BMI值、胰岛素水平、Chemerin、RBP4均高于对照组(GDM A1组与对照组:t值分别为2.41、2.06、12.41、12.69、11.79,均P<0.05;GDM A2组与对照组:t值分别为3.16、2.86、10.93、10.95、10.56,均P<0.05),差异均有统计学意义。GDM A2组的孕中期BMI值高于对照组(t=2.39,P<0.05),差异有统计学意义;GDM A2组的OGTT 0h、1h、2h均高于GDM A1组(t值分别为-4.80、-2.42、-3.66,均P<0.05),差异有统计学意义。GDM A1组与GDM A2组的年龄、孕前BM I值、孕中期BM I值、孕晚期BM I值、胰岛素水平、Chemerin、RBP4等比较差异无统计学意义。结论 Chemerin、RBP4参与了GDM孕妇的胰岛素抵抗,高龄、孕前肥胖是GDM的高危因素,OGTT高值的GDM患者孕晚期病情较重。Objective To investigate the high risk factors and detection indexes of gestational diabetes mellitus（ GDM） with different severity. Methods Chemerin,RBP4 and serum insulin levels of normal pregnant women and pregnant women with GDM were detected in second trimester and tracked to late pregnancy. A total of 218 cases of GDM patients were divided into GDMA1 group（ diet only needed to control blood sugar） and GDMA2 group（ insulin needed to control blood sugar）,and 44 cases of normal pregnant women were in control group. Factors and indicators including maternal age,BMI during pregnancy,Chemerin,RBP4 and insulin level,values of oral glucose tolerance test（ OGTT） were analyzed in three groups of pregnant women. Results Maternal age,pre pregnancy BMI,insulin level,Chemerin and RBP4 of pregnant women in GDMAl group and GDMA2 group were higher than those in control group（ t value was 2. 41,2. 06,12. 41,12. 69 and 11. 79,respectively when comparing GDMA1 group with control group,all P〈0. 05; t value was 3. 16,2. 86,10. 93,10. 95 and 10. 56,respectively when comparing GDMA2 group with control group,all P〈0. 05）. The differences had statistical significance. BMI value in second trimester of pregnant women in GDMA 2 group was higher than that in the control group（ t = 2. 39,P〈0. 05）,and the difference had statistical significance. OGTT value at 0h,1h and 2h of patients in GDMA2 group was higher than that in GDMA1 group（ t value was- 4. 80,- 2. 42 and- 3. 66,respectively,all P〈0. 05）,and the differences had statistical significance.Difference in maternal age,BMI value during pre pregnancy,second trimester pregnancy and late pregnancy,insulin level,Chemerin and RBP4 between GDMA1 group and GDMA2 group had no statistical significance. Conclusion RBP4 and Chemerin play a role in insulin resistance in pregnant women with GDM. Advanced age and pre-pregnancy obesity are high risk factors for GDM. GDM patients with higher OGTT will be more seriously ill in late pregnancy.

关 键 词：妊娠期糖尿病 CHEMERIN RBP4 高危因素 

分 类 号：R714.25[医药卫生—妇产科学]