血清游离脂肪酸与妊娠期糖尿病合并早期肾功能损伤相关性的研究  

Correlations between serum FFA and the early renal function inefficiency in GDM patients

作　　者：刘环宇 冉若曦 刘松梅[2] 张元珍[2] LIU Huanyu;RAN Ruoxi;LIU Songmei(Department of Obstetrics and Gynecology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院妇产科,430071 [2]武汉大学中南医院检验科,430071

出　　处：《中国糖尿病杂志》2020年第6期410-414,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(81472023);湖北省卫生健康委员会创新团队项目(WJ2019C002);联合基金重点项目(WJ2019H005)。

摘　　要：目的探讨血清FFA水平与孕晚期GDM合并早期肾功能损伤的相关性。方法选取2017年5月至2019年2月于我院妇产科住院的302例GDM患者,以血清胱抑素C(CysC)水平(0~1.2 mg/L)为参考,分为单纯GDM患者(GDM组)226例,GDM合并早期肾功能损伤患者(ERFI组)76例。另选取同期我院598例健康孕妇为正常对照组(NGT组)。分析各组血压、血糖、血脂及肾功能指标的差异及相关性。结果ERFI组血压、FFA、FPG、TG、TC、CysC、β2微球蛋白(β2MG)、BUN、血肌酐、血尿酸(SUA)、尿蛋白阳性率、合并妊娠期高血压病发生率均高于GDM及NGT组,HDL-C、eGFR低于GDM、NGT组(P<0.05)。相关分析显示,FFA与CysC、β2MG、SUA呈正相关(P<0.05或P<0.01)。FFA升高组CysC、SUA水平高于FFA正常组(P<0.05)。结论GDM患者FFA升高与早期肾功能损伤相关,提示在控制血糖的同时还应密切关注血脂变化。Objective To investigate whether serum FFA associated with the early renal function inefficiency in the third trimester of GDM pregnant women.Methods 302 GDM patients and age-matched 598 normal controls(NGT)were included in this study.According to the levels of serum cystatin C(Cys C,0~1.2 mg/L),GDM patients were classified into single GDM group and diabetic renal injury group(ERFI).The differences and correlations between different groups or variables were evaluated by SPSS 21.0.Results Compared with the single GDM group,ERFI group had higher levels of blood pressure,serum FFA,FPG,TG,TC,Cys C,β2 MG,BUN,Scr and SUA higher rate of albuminuria and hypertension during pregnancy,lower levels of HDL-C and e GFR.Serum FFA was correlated with the levels of Cys C,β2 MG and SUA(P<0.05 or P<0.01).Compared with normal FFA group,individuals with elevated FFA showed higher Cys C and SUA.Conclusion Increasing serum FFA is related to ERFI in the third trimester of GDM pregnant women,suggesting that both serum glucose and lipids should be under wellcontrolled.

关 键 词：妊娠期糖尿病 游离脂肪酸 胱抑素C 早期肾功能损伤 

分 类 号：R714.256[医药卫生—妇产科学] R714.258[医药卫生—临床医学]