妊娠期糖尿病患者铁代谢及氧化应激水平与胰岛素抵抗相关分析  

Correlation between iron metabolism,oxidative stress and insulin resistance in patients with gestational diabetes mellitus

作　　者：李苑艳 孙素玉 冯泽蛟 Li Yuanyan;Sun Suyu;Feng Zejiao

机构地区：[1]温州市中心医院妇产科,325000

出　　处：《中华内分泌外科杂志》2020年第6期497-501,共5页Chinese Journal of Endocrine Surgery

基　　金：温州市科技计划项目(Y20170131)。

摘　　要：目的探讨妊娠期糖尿病(GDM)患者铁代谢及氧化应激水平与胰岛素抵抗(IR)的关系。方法选择2018年1月至2019年5月在温州市中心医院正规建卡产检并确诊为GDM的68例孕妇作为研究组,同时随机选择同期于本院产检的健康孕妇68例作为对照组。记录并比较两组孕妇铁代谢指标[血清铁蛋白(SF)、血清铁(Fe)、转铁蛋白(TRF)]、氧化应激水平[超氧化物歧化酶(SOD)、核转录因子-κB(NF-κB)、丙二醛(MDA)、总抗氧化能力(TAOC)]、胰岛素抵抗指数(IRI)及胰岛素敏感性指数(ISI);采用Spearman相关系数分析铁代谢、氧化应激水平水平与IRI、ISI相关性。结果研究组的IRI、SF、Fe、TRF、NF-κB、MDA水平分别为(3.77±0.20)、(89.95±8.66)、(36.20±3.25)、(4.22±0.44)、(26.66±1.63)和(22.68±1.70),显著高于对照组的(1.83±0.18)、(82.30±8.86)、(18.92±3.07)、(2.78±0.36)、(15.54±1.44)和(11.97±1.52),组间比较均具体有统计学意义(P<0.05);研究组的ISI、SOD、TAOC水平分别为(0.01±0.01)、(6.07±1.47)、(10.05±1.62),显著低于对照组的(0.05±0.02)、(20.35±1.68)和(12.96±1.63),组间比较均具体有统计学意义(P<0.05);SF、TRF、NF-κB、MDA与ISI呈负相关(P<0.05),SOD、TAOC与ISI呈正相关(P<0.05);SF、TRF、SOD、NF-κB、MDA、TAOC为影响IRI的独立因素(P<0.05)。结论铁代谢、氧化应激水平与IR密切相关,其水平上调可体现IR水平及病情进展;妊娠期间关注并抑制其水平的异常上调来降低IR,对抑制GDM发生与发展有重要价值。Objective To investigate the correlation between iron metabolism,oxidative stress and insulin resistance in patients with gestational diabetes mellitus(GDM).Methods 68 cases of GDM(study group)and 68 healthy individuals(control group)in our hospital from Jan.2018 to May.2019 were enrolled.Various indexes were compared between groups,including iron metabolism indicators[serum ferritin(SF),serum iron(Fe),transferrin(TRF)],oxidative stress indexes[superoxide dismutase(SOD),nuclear transcription factorκB(NF-κB),malondialdehyde(MDA),total antioxidant capacity(TAOC)],insulin resistance index(IRI),and insulin sensitivity index(ISI);Spearman correlation coefficient was used to analyze the correlation between iron metabolism,oxidative stress level,IRI and ISI.Results The levels of IRI,SF,Fe,TRF,NF-κB,and MDA in the study group were(3.77±0.20),(89.95±8.66),(36.20±3.25),(4.22±0.44),(26.66±1.63)and(22.68±1.70),respectively,which were significantly higher than(1.83±0.18),(82.30±8.86),(18.92±3.07),(2.78±0.36),(15.54±1.44)and(11.97±1.52)in the control group(P<0.05);The levels of ISI,SOD,TAOC in the study group were(0.01±0.01),(6.07±1.47)and(10.05±1.62),which were significantly lower than those of the control group of(0.05±0.02),(20.35±1.68)and(12.96±1.63)(P<0.05).SF,TRF,NF-κB,MDA were positively correlated with IRI(P<0.05),while SOD,TAOC was negatively correlated with IRI(P<0.05).SF,TRF,NF-κB,and MDA were significantly negatively correlated with ISI(P<0.05),and SOD,TAOC was significantly positively correlated with ISI(P<0.05).SF,TRF,SOD,NF-κB,MDA,and TAOC were independent risk factors for IRI(P<0.05).Conclusions The level of iron metabolism and oxidative stress indexes is closely related to IR,and its up-regulation can reflect IR level and disease progress.It is of great value to reduce IR by inhibiting abnormal upregulation of iron metabolism and oxidative stress indexes during pregnancy to inhibit the occurrence and development of GDM.

关 键 词：妊娠糖尿病 铁代谢 氧化应激 胰岛素抵抗 

分 类 号：R71[医药卫生—妇产科学] R587.1[医药卫生—临床医学]