GDM孕妇血清Ghrelin、胰岛素原水平与血糖控制及早产的关系  

Relationship between serum Ghrelin, proinsulin levels and blood glucose control and premature delivery in pregnant women with GDM

作　　者：朱林凤 惠玉洁 王硕 ZHU Linfeng;HUI Yujie;WANG Shuo(Department of Gynecology and Obstetrics,Beijing Pinggu Hospital,Beijing 101200,China)

机构地区：[1]北京市平谷区医院妇产科,北京101200

出　　处：《中国优生与遗传杂志》2021年第7期947-951,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的探究妊娠糖尿病(GDM)孕妇母体血清及新生儿脐带血血清促生长激素释放素(Ghrelin)、胰岛素原水平与血糖控制及早产的关系。方法选取我院妇产科156例孕产妇,分为GDM组(n=48例)和健康对照组(n=108例)。检测孕妇母体血清及新生儿脐带血血清Ghrelin、胰岛素原水平。利用糖化血红蛋白A1c(HbA1c)评估血糖控制情况。结果 GDM组母体循环血清Ghrelin及胰岛素原水平低于对照组,且脐带血血清胰岛素原水平高于对照组(P<0.05)。在GDM组中,血糖控制不足亚组(HbA1c≥6.5%)母体外周血清Ghrelin水平低于血糖控制良好亚组(HbA1c<6.5%),同时脐带血清胰岛素原水平高于血糖控制良好亚组(P<0.05)。此外早产孕妇外周血清Ghrelin水平低于足月分娩GDM孕妇,同时脐带血清胰岛素原水平高于足月分娩GDM孕妇(P<0.05)。GDM孕妇外周血清Ghrelin水平、脐带血清胰岛素原水平与新生儿出生体重呈线性关系(rs=–0.314、0.396,P=0.018)。结论 GDM孕妇的高血糖环境可导致母体外周血清Ghrelin水平降低,促进胎儿胰岛素原的分泌,这可能也是GDM孕妇早产风险较高的危险因素之一。Objective To investigate the correlation between serum Ghrelin, proinsulin levels in maternal serum and umbilical cord blood serum in newborn of pregnant women with gestational diabetes mellitus(GDM) and blood glucose control and premature delivery. Methods 156 pregnant women in the department of obstetrics and gynecology of our hospital were selected, which divided into GDM group(n=48) and healthy control group(n=108). The serum Ghrelin and proinsulin levels in maternal peripheral blood and newborn umbilical cord blood were detected. Blood glucose control was assessed using glycated hemoglobin A1 c(HbA1 c). Results The maternal peripheral blood serum Ghrelin and proinsulin levels of pregnant women in GDM group were lower than those in control group, and the newborn umbilical cord blood serum proinsulin levels were higher than those in control group(P<0.05). In GDM group, maternal peripheral blood serum Ghrelin level in the insufficient blood glucose control subgroup(HbA1 c≥6.5%) was lower than that in the good blood glucose control subgroup(HbA1 c<6.5%), and the newborn umbilical cord blood serum proinsulin levels was higher than that in the good blood glucose control subgroup(P<0.05). In addition, the maternal peripheral blood serum Ghrelin levels in pregnant women with GDM and premature delivery were lower than that of the pregnant women with GDM and term delivery, and the newborn umbilical cord blood serum proinsulin levels were higher than that of the pregnant women with GDM and term delivery(P<0.05). Pearson analysis showed that in the GDM group, the maternal peripheral blood serum Ghrelin level and the newborn umbilical cord blood serum proinsulin level were both correlated with birth weight(rs=–0.314, 0.396, P=0.018). Conclusion The hyperglycemic environment of pregnant women with GDM can lead to the decrease of maternal peripheral blood serum Ghrelin level and promote the secretion of proinsulin of fetus, which may also be one of the risk factors for the higher risk of premature delivery in pregnant

关 键 词：妊娠糖尿病 促生长激素释放素 胰岛素原 糖化血红蛋白A1C 

分 类 号：R722.6[医药卫生—儿科]