CAJ | 학술논문

目的探讨妊娠糖尿病患者脂联素和瘦素与胰岛素抵抗之间的关系。方法采用病例对照法，分别测定30例单纯妊娠糖尿病组及30名健康妊娠组的空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、总胆固醇（TC）、甘油三酯（TG），计算胰岛素抵抗指数（HOMA-IR），同时测定血清瘦素和脂联素，观察各指标的差异，分析其相互关系。结果与健康妊娠组比较，妊娠糖尿病组患者的FBG、FINS、TG、TC、瘦素、低密度脂蛋白胆固醇明显升高，存在更明显的胰岛素抵抗。脂联素有显著的降低，高密度脂蛋白胆固醇差异无统计学意义（P<0.05）。多元回归分析显示妊娠糖尿病患者胰岛素抵抗与瘦素呈正相关，与脂联素呈负相关。结论低水平脂联素是妊娠糖尿病胰岛素抵抗的危险因素，且胰岛素抵抗与血清瘦素水平密切相关，因此积极给予外源性拮抗瘦素及提高脂联素水平的药物可能成为治疗妊娠糖尿病的一种方案。
목적탐토임신당뇨병환자지련소화수소여이도소저항지간적관계。방법채용병례대조법，분별측정30례단순임신당뇨병조급30명건강임신조적공복혈당（FBG）、당화혈홍단백（HbA1c）、공복이도소（FINS）、총담고순（TC）、감유삼지（TG），계산이도소저항지수（HOMA-IR），동시측정혈청수소화지련소，관찰각지표적차이，분석기상호관계。결과여건강임신조비교，임신당뇨병조환자적FBG、FINS、TG、TC、수소、저밀도지단백담고순명현승고，존재경명현적이도소저항。지련소유현저적강저，고밀도지단백담고순차이무통계학의의（P<0.05）。다원회귀분석현시임신당뇨병환자이도소저항여수소정정상관，여지련소정부상관。결론저수평지련소시임신당뇨병이도소저항적위험인소，차이도소저항여혈청수소수평밀절상관，인차적겁급여외원성길항수소급제고지련소수평적약물가능성위치료임신당뇨병적일충방안。
Objective To study correlation between the insulin resistancce, adiponectin and leptin in patients with gestational diabetes mellitus. Methods A case-match study was carried out. Fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol(LDL-C), adiponectin(ADP) and leptin(LEP) were measured in 30 gestational diabetes mellitus (group A) and 30 pregnant women with normal glucose tolerance(group B), retrospectively. Insulin resistance(HOMA-IR) was calculated. The changes of the indicators were observed and their correlation were analyzed. Results Compared with group B, FBG, FINS, TG, TC, ADP, LDL-C were significantly increased(P<0.05). LEP was significantly reduced and HDL-C was no significantly changed in group A. Multiple regression analysis showed that there was negative correlation between LEP and IR and positively with ADP. Conclusion Lower ADP may be a risk factor for gestational diabetes mellitus with insulin resistance. And insulin resistance closely related to serum LEP. Actively improve the ADP and giving extrinsic anti-LEP drugs maybe provide a new avenue to the treatment of gestional diabetes mellitus.