孕早期性激素结合球蛋白、炎症因子及血脂水平与妊娠期糖尿病的关系分析  

Relationships Among Sex Hormone Binding Globulin,Inflammatory Factors and Levels of Blood Lipids in Early Pregnancy and Gestational Diabetes Mellitus

作　　者：罗剑波[1] 邓洁[1] 

机构地区：[1]成都医学院第一附属医院妇科,四川成都610500

出　　处：《标记免疫分析与临床》2018年第1期73-77,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨孕早期性激素结合球蛋白及白细胞水平与妊娠期糖尿病的关系。方法将符合妊娠期糖尿病(GDM)诊断标准的35例GDM孕妇作为GDM组,42例葡萄糖耐量正常孕妇作为NGT组,同时选取同期体检正常的30例孕龄女性作为对照组,收集三组受试者的一般资料并检测受试者实验室检测指标,并对有差异的指标进行Spearman相关性分析,同时对显著性因素进行多元Logistic回归分析。结果与对照组相比,GDM组和NGT组受试者FINS、HOMA-IR、hs-CRP、TG、LDL-C指标均显著升高(P<0.05),而SHBG指标显著降低(P<0.05),与NGT组比较,GDM组FBG、FINS、HOMA-IR、hs-CRP、TG和LDL-C均显著升高(P<0.05),而SHBG指标显著降低(P<0.05)。GDM组中SHBG与FINS、HOMA-IR和hs-CRP呈负相关(r=-0.233,-0.412和-0.512,P<0.05),而与FBG、TG和LDL-C均无相关性,GDM组中HOMA-IR和hs-CRP呈显著正相关(r=0.027,P<0.05)。经多元Logistic回归分析,发现血清SHBG水平与GDM发生呈显著负相关(P<0.05),而hs-CRP、FINS和HOMA-IR与GDM发生呈显著正相关(P<0.05)。结论孕早期低水平SHBG是GDM发生的独立危险性因素,对孕早期妇女进行SHBG检测,能够预测GDM发生危险程度。Objective To investigate the relationship between levels of sex hormone binding globulin（SHBG） and white blood cells（WBC） in early pregnancy and gestational diabetes mellitus（GDM）. Methods 35 cases of pregnant women with GDM were selected as GDM group ,42 cases of normal pregnant women with normal glucose tolerance（NGT） were selected as NGT group and 30 cases of normal healthy pregnant women were selected as control group within the same period. The general data of three groups were collected and the laboratory indexes were detected. Factors with differences were analyzed by Spearman correlation analysis and factors with significant differences were analyzed by multivariate Logistic regression analysis. Results The fasting insulin （ FINS ）, homeostatic model assessment for insulin resistance （ HOMA-IR ） index, high- sensitivity C reactive protein （ hs- CRP）, triglyceride （ TG ） and low- density lipoprotein cholesterol （ LDL- C ） were significantly higher while SHBG was significantly lower in GDM group and NGT group than those in the control group （ P 〈 0.05 ）. The FBG, FINS, HOMA- IR, hs- CRP, TG and LDL- C were significantly higher while SHBG was significantly lower in the GDM group than those in NGT group（ P 〈 0.05 ）. In GDM group, SHBG was negative correlated with FINS, HOMA-IR and hs-CRP（ r = -0. 233, -0. 412, -0. 512,P 〈 0.05）. There was no correlation between SHBG and FBG, TG, LDL-C. In GDM group, HOMA-IR was significantly positively correlated with hs-CRP（ r = 0. 027, P 〈 0.05 ）. Multivariate Logistic regression analysis showed that serum SHBG level was negatively correlated with GDM （ P 〈 0.05 ）, while hs- CRP, FINS and HOMA-IR were positively correlated with GDM（ P 〈 0.05 ）. Conclusion Low SHBG level in early pregnancy is an independent risk factor for GDM. The detection of SHBG can be used to predict the risk of GDM.

关 键 词：孕早期 性激素结合球蛋白 白细胞水平 妊娠期糖尿病 

分 类 号：R714.256[医药卫生—妇产科学]