妊娠糖尿病合并骨质疏松孕妇血清瘦素、脂联素水平与骨代谢指标的相关性研究  

Correlation between serum leptin, adiponectin levels and bone metabolism indexes in pregnant women with gestational diabetes mellitus complicated with osteoporosis

作　　者：张玲 贺喜风 张晶 杨彩霞 吴媛霞[2] Zhang Ling;He Xifeng;Zhang Jing;Yang Caixia;Wu Yuanxia(Department of Obstetrics and Gynecology,Shanxi Children's Hospital,Shanxi Maternal and Child Health Hospital,Taiyuan 030006,China;Reproductive Center,Shanxi Women and Children's Health Hospital,Taiyuan 030006,China)

机构地区：[1]山西省儿童医院、山西省妇幼保健院妇产科,太原030006 [2]山西省儿童医院、山西省妇幼保健院医学生殖中心,太原030006

出　　处：《中华内分泌外科杂志（中英文）》2024年第4期544-548,共5页Chinese Journal of Endocrine Surgery

基　　金：山西省科学技术厅基金项目(202303021211064)。

摘　　要：目的分析妊娠期糖尿病(gestational diabetes mellitus,GDM)合并骨质疏松孕妇的血清瘦素(leptin,LEP)、脂联素(adiponectin,ADP)水平与骨代谢指标的相关性。方法将2020年12月至2023年12月山西省儿童医院收治的120例GDM孕妇纳入观察组,同期本院孕检的30例健康孕妇纳入对照组,对比两组血清LEP、ADP、骨代谢指标[甲状旁腺激素(parathyroid hormone,PTH)、碱性磷酸酶(alkaline phosphatase,ALP)、25-羟基维生素D、氨基端和中段骨钙素(amino terminal and mid-osteocalcin,N-MID)]水平。将GDM合并骨质疏松孕妇纳入骨质疏松组,未合并骨质疏松的孕妇纳入非骨质疏松组,比较两组孕妇血清LEP、ADP、骨代谢指标(PTH、ALP、25-羟基维生素D、N-MID)水平,采用Pearson相关性分析血清LEP、ADP与PTH、ALP、25-羟基维生素D、N-MID的关系,绘制受试者工作特征(receiver operating characteristics,ROC)曲线评估血清LEP、ADP水平对GDM合并骨质疏松的诊断价值。结果观察组LEP水平高于对照组,ADP、PTH、25-羟基维生素D、N-MID水平低于对照组(t=10.08、7.19、12.70、15.05、20.54,P<0.05),两组ALP水平比较差异无统计学意义(t=0.78,P>0.05)。GDM合并骨质疏松25例,不合并骨质疏松95例,骨质疏松组LEP水平明显高于非骨质疏松组,ADP、PTH、25-羟基维生素D、N-MID水平明显低于非骨质疏松组(t=4.44、3.06、3.51、3.18、3.00,P<0.05),两组ALP水平比较差异无统计学意义(t=0.38,P>0.05)。Pearson相关分析显示,GDM孕妇血清LEP、ADP与PTH、25-羟基维生素D、N-MID均有显著相关(P<0.05);血清LEP、ADP、联合检测诊断GDM孕妇合并骨质疏松的曲线下面积(area under the curve,AUC)分别为0.723、0.650、0.755。结论GDM合并骨质疏松孕妇血清LEP水平明显上升,ADP水平明显下降,与孕妇骨代谢指标密切相关,并可协助临床早期诊断GDM合并骨质疏松。ObjectiveTo analyze the correlation between serum leptin(LEP),adiponectin(ADP)levels and bone metabolism indexes in pregnant GDM women complicated with osteoporosis.MethodsA total of 120 GDM patients admitted to our hospital from Dec.2020 to Dec.2023 were included as the observation group,and 30 healthy pregnant women were chosen as the control group.The levels of serum LEP,ADP,bone metabolism indexes[parathyroid hormone(PTH),alkaline phosphatase(ALP),25-hydroxyvitamin D,amino terminal and middle osteocalcin(N-MID)]were compared.The relationship between serum LEP,ADP and PTH,ALP,25-hydroxyvitamin D and N-MID was analyzed by Pearson correlation,and receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of serum LEP and ADP levels in gestational diabetes mellitus complicated with osteoporosis.ResultsThe observation group had higher LEP level,but lower ADP,PTH,25-hydroxyvitamin D and N-MID level(t=10.08,7.19,12.70,15.05,20.54,P<0.05),and there was no significant difference in ALP between the two groups(t=0.78,P>0.05);25 had osteoporosis and 95 did not.LEP levels in the osteoporosis subgroup were significantly higher than those in the non-osteoporosis subgroup,and ADP,PTH,25-hydroxyvitamin D and N-MID levels were significantly lower(t=4.44,3.06,3.51,3.18,3.00,P<0.05).There was no significant difference in ALP level between the two groups(t=0.38,P>0.05).Pearson correlation analysis showed that serum LEP and ADP were significantly correlated with PTH,25-hydroxyvitamin D and N-MID in pregnant GDM women(P<0.05).The area under the curve(AUC)of serum LEP,ADP and combined test in pregnant GDM women complicated with osteoporosis were 0.723,0.650 and 0.755,respectively.ConclusionSerum LEP level increases and ADP level decreases significantly in pregnant GDM women complicated with osteoporosis,which is closely related to bone metabolism indexes,and can assist in early diagnosis of gestational diabetes mellitus complicated with osteoporosis.

关 键 词：糖尿病 妊娠糖尿病 骨质疏松 孕妇 瘦素 脂联素 骨代谢 

分 类 号：R714.256[医药卫生—妇产科学]