趋化素在口服葡萄糖耐量试验异常孕妇中的临床表达及意义  

The expression and significance of chemerin in pregnant women with abnormal glucose tolerance test

作　　者：钱俏[1] 储莉鸣[1] 褚水莲 刘朋飞[1] 金莲华 沈丽华[1] 胡逸凡 马梓汶 王永兴 张治萍[1] QIAN Qiao;CHU Li-ming;CHU Shui-lian;LIU Peng-fei;JIN Lian-hua;SHEN Li-hua;HU Yi-fan;MA Zi-wen;WANG Yong-xing;ZHANG Zhi-ping(Department of obstetrics and gynecology,Shanghai Pudong Health care hospital for Women and Children,Shanghai 201206,China)

机构地区：[1]上海市浦东新区妇幼保健院,上海201206

出　　处：《中国妇幼保健》2023年第16期2948-2952,共5页Maternal and Child Health Care of China

基　　金：上海市浦东新区科技发展基金项目(PKJ2016-Y48);上海市浦东新区卫生系统医学学科建设资助项目(PWYts2021-19)。

摘　　要：目的探讨趋化素(chemerin)在口服葡萄糖耐量试验(OGTT)异常孕妇外周血及脐血中的表达及意义。方法2017年1月—2018年6月在上海市浦东新区妇幼保健院产科门诊定期产检并住院待产的OGTT异常孕妇患者305例及正常对照孕妇413例,采集外周及脐血,并测定血糖代谢、血脂代谢等的指标。结果(1)OGTT异常孕妇组孕妇外周血、脐血chemerin显著高于对照组,两组外周血chemerin均高于脐血chemerin,差异有统计学意义(P<0.05)。(2)OGTT异常孕妇组孕妇年龄、孕前体质量、孕前BMI、分娩前BMI、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、稳态模式胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、新生儿身高、体质量及BMI均显著高于对照组(P>0.05)。OGTT异常孕妇组孕24周~分娩前增重率、孕期总体质量增加、高密度脂蛋白胆固醇(HDL-C)低于正常对照组(P<0.05)。两组间孕14~24周增重率、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、新生儿Apgar评分差异无统计学意义(P>0.05)。(3)正常对照组chemerin与年龄、FPG及HOMA-IR呈正相关,与孕前BMI、孕期增重、分娩前BMI及HDL-C呈负相关,OGTT异常孕妇组外周血chemerin与上述指标之间无相关性。OGTT异常孕妇组孕妇脐带血chemerin与新生儿体质量、新生儿BMI呈正相关,而正常对照组脐带血chemerin与新生儿体质量、新生儿BMI无相关性。回归分析显示OGTT异常孕妇组有更高的外周血、脐血chemerin水平。结论血chemerin可能作为一个独立的影响因素,在OGTT异常孕妇代谢过程中,参与重要调节。Objective To study the expression and significance of chemerin in peripheral blood and umbilical cord blood of pregnant women with abnormal glucose tolerance test.Methods 305 cases of pregnant women with abnormal glucose tolerance test treated in in Shanghai Pudong Health care hospital for Women and Children from January 2017 to June 2018 were selected as the observation group,and other 413 cases of healthy pregnant women in the same period were selected as the control group.Peripheral blood and umbilical cord blood were collected to determine the content of blood glucose metabolism and lipid metabolism as well as other indicators.Results①Chemerin in peripheral blood and umbilical cord blood of the pregnant women with abnormal glucose tolerance test group was significantly higher than that in the control group,and chemerin in peripheral blood of both groups was higher than that in umbilical cord blood(P<0.05).②Age and pre-pregnancy weight of the pregnant women with abnormal glucose tolerance test group were significantly higher than those of the control group as well as pre-pregnancy BMI,BMI at delivery,fasting blood glucose(FPG),fasting insulin(FINS),glyca1c(HbA1c),ho⁃meostatic insulin resistance index(HOMA-IR),triglyceride(TG),neonatal height,neonatal weight and neonatal BMI(P>0.05).The weight gain rate before 24-week pregnancy,the total weight increase during pregnancy,and the high-density lipoprotein cholesterol(HDL-C)were lower in pregnant women with abnormal glucose tolerance test group than that in control group(P<0.05).There was no significant difference between the two groups in the weight gain rate at 14-24 weeks of gestation,total cholesterol(TC),low density lipo⁃protein cholesterol(LDL-C)and neonatal Apgar score(P>0.05).③In the control group,chemerin was positively correlated with age,FPG and HOMA-IR,and negatively correlated with pre-pregnancy BMI,pregnancy weight gain,BMI at delivery and high density lipopro⁃tein cholesterol(HDL-C),while there was no correlation between peripheral blood

关 键 词：葡萄糖耐量试验异常孕妇 趋化素 胰岛素抵抗 

分 类 号：R714[医药卫生—妇产科学]