中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2014年
8期
584-587
,共4页
霍琰%刘素新%冯静%李红艳%范艳丽%靳颖%李丽
霍琰%劉素新%馮靜%李紅豔%範豔麗%靳穎%李麗
곽염%류소신%풍정%리홍염%범염려%근영%리려
糖尿病,妊娠%烟酰胺磷酸核糖基转移酶%胰岛素抗药性
糖尿病,妊娠%煙酰胺燐痠覈糖基轉移酶%胰島素抗藥性
당뇨병,임신%연선알린산핵당기전이매%이도소항약성
Diabetes,gestational%Nicotinamide phosphoribosyltransferase%Insulin resistance
目的 探讨内脂素在妊娠期糖尿病(GDM)发病中的作用及其与胰岛素抵抗的相关性.方法 选择2013年1月至6月于河北省人民医院妇产科就诊的孕24～ 28周的单胎孕妇58例,根据75 g口服葡萄糖耐量试验(OGTT)结果,分为GDM组30例和健康妊娠(NGT)组28例;同期在体检中心健康体检的糖耐量正常的2型糖尿病一级亲属妇女14例作为高危对照组,糖耐量正常的健康未孕育龄妇女27例为正常对照组.采用葡萄糖氧化酶法检测各组妇女空腹血糖(FPG)、餐后1h及2h血糖水平;采用放射免疫法检测各组妇女空腹胰岛素(FIN)水平并计算稳态模型胰岛素抵抗指数(HOMA-IR);检测各组妇女的总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)水平;ELISA法测定血清内脂素水平.结果 (1)GDM组、高危对照组和正常对照组妇女的FPG水平[分别为(5.5±0.7)、(5.1±0.6)、(5.2±0.4)mmol/L]明显高于NGT组[(4.5±0.3)mmol/L],分别比较,差异均有统计学意义(P＜0.05).(2)GDM组妇女FIN水平[(14±6)mU/L]、HOMA-IR(4.0±2.0)、餐后1 h[(10.9±1.8) mmol/L]及2 h[(8.6±1.8) mmol/L]血糖水平,明显高于NGT组[分别为(12±4) mU/L、2.0±1.0、(7.4±1.3)及(6.2±0.9)mmol/L],分别比较,差异均有统计学意义(P＜0.05).(3)GDM组妇女TC、TG、HDL及LDL水平分别为(5.5±0.9)、(2.8±0.8)、(1.8±0.4)及(3.3±0.8)mmol/L,NGT组妇女分别为(5.9±0.8)、(2.5±0.7)、(1.9±0.4)及(3.4±0.6) mmol/L,两组妇女血脂水平均明显高于高危对照组及正常对照组,分别比较,差异均有统计学意义(P＜0.05).(4)GDM组及NGT组妇女血清内脂素水平[分别为(43±10)、(45±12) μg/L]显著高于高危对照组及正常对照组[分别为(29±9)、(36±7) μg/L],分别比较,差异均有统计学意义(P＜0.05);但高危对照组妇女血清内脂素水平则明显低于正常对照组,差异有统计学意义(P＜0.05);GDM组妇女血清内脂素水平虽略低于NGT组,但差异无统计学意义(P＞0.05).(5)NGT组妇女内脂素水平与FPG、HOMA-IR和TC呈负相关(r=-0.38、-0.44、-0.47,P＜0.05).GDM组妇女内脂素水平与FPG、HOMA-IR和TC均无相关性(r=-0.16、-0.01、0.33,P＞0.05).而正常对照组血清内脂素水平与FPG和餐后2h血糖呈负相关(r=-0.48、-0.42,P＜0.05).结论 内脂素可能是参与GDM妇女糖及脂肪代谢的重要脂肪因子,并与GDM发病和胰岛素抵抗相关.
目的 探討內脂素在妊娠期糖尿病(GDM)髮病中的作用及其與胰島素牴抗的相關性.方法 選擇2013年1月至6月于河北省人民醫院婦產科就診的孕24～ 28週的單胎孕婦58例,根據75 g口服葡萄糖耐量試驗(OGTT)結果,分為GDM組30例和健康妊娠(NGT)組28例;同期在體檢中心健康體檢的糖耐量正常的2型糖尿病一級親屬婦女14例作為高危對照組,糖耐量正常的健康未孕育齡婦女27例為正常對照組.採用葡萄糖氧化酶法檢測各組婦女空腹血糖(FPG)、餐後1h及2h血糖水平;採用放射免疫法檢測各組婦女空腹胰島素(FIN)水平併計算穩態模型胰島素牴抗指數(HOMA-IR);檢測各組婦女的總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)水平;ELISA法測定血清內脂素水平.結果 (1)GDM組、高危對照組和正常對照組婦女的FPG水平[分彆為(5.5±0.7)、(5.1±0.6)、(5.2±0.4)mmol/L]明顯高于NGT組[(4.5±0.3)mmol/L],分彆比較,差異均有統計學意義(P＜0.05).(2)GDM組婦女FIN水平[(14±6)mU/L]、HOMA-IR(4.0±2.0)、餐後1 h[(10.9±1.8) mmol/L]及2 h[(8.6±1.8) mmol/L]血糖水平,明顯高于NGT組[分彆為(12±4) mU/L、2.0±1.0、(7.4±1.3)及(6.2±0.9)mmol/L],分彆比較,差異均有統計學意義(P＜0.05).(3)GDM組婦女TC、TG、HDL及LDL水平分彆為(5.5±0.9)、(2.8±0.8)、(1.8±0.4)及(3.3±0.8)mmol/L,NGT組婦女分彆為(5.9±0.8)、(2.5±0.7)、(1.9±0.4)及(3.4±0.6) mmol/L,兩組婦女血脂水平均明顯高于高危對照組及正常對照組,分彆比較,差異均有統計學意義(P＜0.05).(4)GDM組及NGT組婦女血清內脂素水平[分彆為(43±10)、(45±12) μg/L]顯著高于高危對照組及正常對照組[分彆為(29±9)、(36±7) μg/L],分彆比較,差異均有統計學意義(P＜0.05);但高危對照組婦女血清內脂素水平則明顯低于正常對照組,差異有統計學意義(P＜0.05);GDM組婦女血清內脂素水平雖略低于NGT組,但差異無統計學意義(P＞0.05).(5)NGT組婦女內脂素水平與FPG、HOMA-IR和TC呈負相關(r=-0.38、-0.44、-0.47,P＜0.05).GDM組婦女內脂素水平與FPG、HOMA-IR和TC均無相關性(r=-0.16、-0.01、0.33,P＞0.05).而正常對照組血清內脂素水平與FPG和餐後2h血糖呈負相關(r=-0.48、-0.42,P＜0.05).結論 內脂素可能是參與GDM婦女糖及脂肪代謝的重要脂肪因子,併與GDM髮病和胰島素牴抗相關.
목적 탐토내지소재임신기당뇨병(GDM)발병중적작용급기여이도소저항적상관성.방법 선택2013년1월지6월우하북성인민의원부산과취진적잉24～ 28주적단태잉부58례,근거75 g구복포도당내량시험(OGTT)결과,분위GDM조30례화건강임신(NGT)조28례;동기재체검중심건강체검적당내량정상적2형당뇨병일급친속부녀14례작위고위대조조,당내량정상적건강미잉육령부녀27례위정상대조조.채용포도당양화매법검측각조부녀공복혈당(FPG)、찬후1h급2h혈당수평;채용방사면역법검측각조부녀공복이도소(FIN)수평병계산은태모형이도소저항지수(HOMA-IR);검측각조부녀적총담고순(TC)、감유삼지(TG)、고밀도지단백(HDL)급저밀도지단백(LDL)수평;ELISA법측정혈청내지소수평.결과 (1)GDM조、고위대조조화정상대조조부녀적FPG수평[분별위(5.5±0.7)、(5.1±0.6)、(5.2±0.4)mmol/L]명현고우NGT조[(4.5±0.3)mmol/L],분별비교,차이균유통계학의의(P＜0.05).(2)GDM조부녀FIN수평[(14±6)mU/L]、HOMA-IR(4.0±2.0)、찬후1 h[(10.9±1.8) mmol/L]급2 h[(8.6±1.8) mmol/L]혈당수평,명현고우NGT조[분별위(12±4) mU/L、2.0±1.0、(7.4±1.3)급(6.2±0.9)mmol/L],분별비교,차이균유통계학의의(P＜0.05).(3)GDM조부녀TC、TG、HDL급LDL수평분별위(5.5±0.9)、(2.8±0.8)、(1.8±0.4)급(3.3±0.8)mmol/L,NGT조부녀분별위(5.9±0.8)、(2.5±0.7)、(1.9±0.4)급(3.4±0.6) mmol/L,량조부녀혈지수평균명현고우고위대조조급정상대조조,분별비교,차이균유통계학의의(P＜0.05).(4)GDM조급NGT조부녀혈청내지소수평[분별위(43±10)、(45±12) μg/L]현저고우고위대조조급정상대조조[분별위(29±9)、(36±7) μg/L],분별비교,차이균유통계학의의(P＜0.05);단고위대조조부녀혈청내지소수평칙명현저우정상대조조,차이유통계학의의(P＜0.05);GDM조부녀혈청내지소수평수략저우NGT조,단차이무통계학의의(P＞0.05).(5)NGT조부녀내지소수평여FPG、HOMA-IR화TC정부상관(r=-0.38、-0.44、-0.47,P＜0.05).GDM조부녀내지소수평여FPG、HOMA-IR화TC균무상관성(r=-0.16、-0.01、0.33,P＞0.05).이정상대조조혈청내지소수평여FPG화찬후2h혈당정부상관(r=-0.48、-0.42,P＜0.05).결론 내지소가능시삼여GDM부녀당급지방대사적중요지방인자,병여GDM발병화이도소저항상관.
Objective To investigate the role of visfatin in the pathogenesis of gestational diabetes mellitus (GDM)and its correlation with insulin resistance.Methods The study recruited 58 pregnant women of 24 to 28 gestational weeks in People' s Hospital of Hebei Province from January to June 2013.Among them,30 were patients with GDM (GDM group),28 had normal oral glucose tolerance test and was referred as healthy pregnancy group (NGT group).Fourteen age-matched female who were first-degree relatives (FDR1)of type 2 diabetes mellitus patients,and 27 healthy nonpregnant women with normal oral glucose tolerance test were referred as high-risk group and normal controls (NC),respectively.The fasting plasma glucose (FPG),1 hour and 2 hours postprandial glucose levels were measured by glucose oxidase method.The fasting insulin (FIN)levels were measured by radioimmunoassay and the homeostatic model assessment-insulin resistance index (HOMA-IR)was calculated.The levels of total cholesterol (TC),triglycerdes (TG),high density lipoprotein cholesterol (HDL)and low density lipoprotein cholesterol (LDL)were determined.The visfatin levels were measured by ELISA.Results (1)The levels of FPG were significantly higher in GDM,FDRI and NC group [(5.5±0.7),(5.1±0.6),(5.2±0.4) mmol/L] than that in NGT group [(4.5 ± 0.3) mmol/L],respectively (P＜0.05).(2) The levels of INS [(14 ± 6) mU/L],HO MA-I R (4.0±2.0),1 hour [(10.9± 1.8) mmol/L] and 2 hours [(8.6± 1.8) mmol/L] postprandial glucose levels of GDM group were significantly higher than those in NGT group [(12±4) mU/L,2.0± 1.0,(7.4± 1.3) and (6.2 ±0.9) mmol/L],respectively (P＜0.05).(3)The levels of TC,TG,HDL and LDL levels in GDM group were (5.5±0.9),(2.8±0.8),(1.8±0.4)and(3.3±0.8) mmol/L,and were(5.9 ± 0.8),(2.5 ± 0.7),(1.9 ± 0.4) and (3.4 ± 0.6) mmol/L in NGT group.The levels of lipid in the two groups were significantly higher than those in FDR 1 or NC group,respectively (P＜0.05).(4) The levels of visfatin in GDM group and NGT group [(43 ± 10),(45 ± 12) μg/L] were significantly higher than that in FDR1 or NC group [(29±9),(36±7) μg/L],respectively (P＜0.05),but the visfatin levels in FDR 1 group were significantly lower than that in NC group (P＜0.05).The visfatin levels in GDM group were slightly lower than that in NGT group,but the difference was not statistically significant (P＞0.05).(5)The visfatin levels in NGT group were negatively correlated to the levels of FPG,HOMA-IR and TC(r=-0.38,-0.44,-0.47,respectively,P＜0.05).But the visfatin levels in GDM group were not correlated with the levels of FPG,HOMA-IR,TC (r=-0.16,-0.01,0.33,respectively,P＞ 0.05).While in NC group,the levels of visfatin were negatively correlated with FPG and 2 hours postprandial glucose (r=-0.48,-0.42,respectively,P＜0.05).Conclusion Visfatin may be an important adipokine that involved in the carbohydrate and lipid metabolism in GDM,and is related to the pathogensis of GDM and insulin resistance.
