CAJ | 학술논문

目的探讨妊娠期糖尿病(GDM)孕妇血清载脂蛋白M(ApoM)与胰岛素和瘦素之间的关系.方法 GDM孕中期组(孕24～ 28周)87例、孕晚期组(分娩前1周)122例,对照组为同孕期正常孕妇,检测血清中载脂蛋白M (ApoM)、胰岛素、瘦素的表达水平,分析指标间的相关性.结果孕中期GDM孕妇ApoM表达水平(0.029±0.010) g/L显著低于同孕期正常对照组(0.036±0.013) g/L(t=-4.168,P=0.0001),孕晚期GDM孕妇ApoM表达水平(0.028 ±0.010) g/L显著高于同孕期正常对照组(0.023±0.008) g/L(t=3.529,P=0.0005).孕中期GDM组的胰岛素表达水平、胰岛素抵抗指数均高于同孕期正常对照组[胰岛素表达水平:12.975 (7.968～22.237)比6.885 (4.805～10.015) μg/L,Z=-5.618,P=0.000;胰岛素抵抗指数2.808(1.705 ～5.158)比1.336 (0.897 ～ 1.925),Z=-6.305,P=0.000],瘦素水平[0.026 (0.015～0.044)比0.024(0.014 ～0.036) ng/L]两组比较差异无统计学意义(Z=-0.927,P=0.354);孕晚期GDM组和同孕期正常对照组比较,胰岛素表达水平[9.5 (5.645 ～13.265)比9.82(6.708 ～15.885)μg/L,Z =0.971,P=0.332]、胰岛素抵抗指数[1.637 (0.977～2.471)比1.781 (1.121 ～2.686),Z=0.904,P=0.366]和瘦素[0.025 (0.015～0.044)比0.029 (0.015 ～0.043) ng/L,Z=0.494,P=0.621]差异均无统计学意义.采用多因素非条件Logistic回归分析显示,ApoM表达水平是GDM的独立危险因素.结论妊娠期糖尿病孕妇血清ApoM表达异常,ApoM可能与GDM的发生有一定的关系,但胰岛素和瘦素与ApoM之间无相关性.
목적 탐토임신기당뇨병(GDM)잉부혈청재지단백M(ApoM)여이도소화수소지간적관계.방법 GDM잉중기조(잉24～ 28주)87례、잉만기조(분면전1주)122례,대조조위동잉기정상잉부,검측혈청중재지단백M (ApoM)、이도소、수소적표체수평,분석지표간적상관성.결과 잉중기GDM잉부ApoM표체수평(0.029±0.010) g/L현저저우동잉기정상대조조(0.036±0.013) g/L(t=-4.168,P=0.0001),잉만기GDM잉부ApoM표체수평(0.028 ±0.010) g/L현저고우동잉기정상대조조(0.023±0.008) g/L(t=3.529,P=0.0005).잉중기GDM조적이도소표체수평、이도소저항지수균고우동잉기정상대조조[이도소표체수평:12.975 (7.968～22.237)비6.885 (4.805～10.015) μg/L,Z=-5.618,P=0.000;이도소저항지수2.808(1.705 ～5.158)비1.336 (0.897 ～ 1.925),Z=-6.305,P=0.000],수소수평[0.026 (0.015～0.044)비0.024(0.014 ～0.036) ng/L]량조비교차이무통계학의의(Z=-0.927,P=0.354);잉만기GDM조화동잉기정상대조조비교,이도소표체수평[9.5 (5.645 ～13.265)비9.82(6.708 ～15.885)μg/L,Z =0.971,P=0.332]、이도소저항지수[1.637 (0.977～2.471)비1.781 (1.121 ～2.686),Z=0.904,P=0.366]화수소[0.025 (0.015～0.044)비0.029 (0.015 ～0.043) ng/L,Z=0.494,P=0.621]차이균무통계학의의.채용다인소비조건Logistic회귀분석현시,ApoM표체수평시GDM적독립위험인소.결론 임신기당뇨병잉부혈청ApoM표체이상,ApoM가능여GDM적발생유일정적관계,단이도소화수소여ApoM지간무상관성.
Objective To explore the relationship of serum apolipoprotein M (ApoM) with insulin and leptin in pregnant women with gestational diabetes mellitus (GDM).Methods Totally 209 pregnant women with GDM (87 in the second trimester and 122 in the third trimester) and 221 normal pregnant women (99 in the second trimester and 122 in the third trimester) were enrolled in this study.Serum ApoM,insulin and leptin levels were determined.Results The serum ApoM level of GDM women in the second trimester was significantly lower than that in controls [(0.029 ±0.010) g/L vs (0.036 ±0.013) g/L,t =-4.168,P =0.0001)] ; also,the serum ApoM level of GDM women in the third trimester was significantly higher than that of controls [(0.028 ±0.010) g/L vs (0.023 ±0.008) g/L,t =3.529,P =0.0005)].The serum insulin levels and insulin resistance index of GDM women in the second trimester were significantly higher than those of controls [insulin levels:12.975 (7.968-22.237) μg/L vs 6.885 (4.805-10.015) μg/L,Z =-5.618,P =0.000; insulin resistance index:2.808 (1.705-5.158) vs 1.336 (0.897-1.925),Z =-6.305,P =0.000].Multivariate non-conditional Logstie regression analysis showed that there was statistical difference of ApoM level between GDM women and controls after adjusting for potential conflounders (GDM in the second trimester,Z =-3.69,P =0.020; GDM in the third trimester,Z =-2.25,P =0.025).Conclusions The serum ApoM levels is abnormal in pregnant women with GDM.ApoM may play a role in the development of GDM; however,no correlation exists between ApoM and insulin/leptin.