妊娠期糖尿病血清脂联素与胰岛素抵抗和分泌的相关性研究

The study on the relationship between the serum adiponectin and insulin resistance and secretion in the GDM patients.

目的 探讨不同糖耐量孕妇血清脂联素与胰岛素抵抗和胰岛 β细胞分泌功能的关系。 方法 2 0 0 3年1月至 2 0 0 4年 1月广东省妇幼保健院和佛山市妇幼保健院采用稳态模型评估法 (HOMA)分别评估正常糖耐量孕妇 (NGT)、糖耐量减低孕妇 (GIGT)和妊娠期糖尿病患者 (GDM)的胰岛素抵抗指数 (HOMA IR)和胰岛 β细胞功能指数 (HBCI) ;利用放免法检测三组孕妇的血清脂联素水平。结果 (1)GDM组HOMA IR显著高于GIGT组 (P <0 0 5 )和NGT组 (P <0 0 0 1) ,三组的HBCI则差异无显著性。 (2 )血清脂联素水平由NGT、GIGI到GDM呈逐步下降态势 (P <0 0 0 1) ;多元回归分析提示HOMA IR、孕晚期体重、孕晚期BMI是影响血清脂联素水平的最显著因素(r2 =0 4 84 ,P <0 0 0 1)。结论 GDM和GIGT患者血清脂联素显著降低 ,并以GDM降低最为明显 ;其脂联素水平的改变与胰岛素敏感性高度相关。

Objective To explore the relationship between adiponectin and insulin resistance and β-c ell function.Methods Homeostasis model assessment (HOMA) was adopted to evaluate IR index and β-cel l function index in the pregnancies with different glucose tolerance.And radioimm unoassay was applied to detect the serum adiponectin level in these three groups from Jan.2003 to Jan.2004. Results (1)HOMA-IR in the GDM group was significantly higher than those in the GIGT gro up (P<0\^05) and the NGT group (P<0\^001),but there was no significant d ifference in the HOMA-β among three groups.(2)In the NGT,GIGI and GDM group,th e serum adiponectin level tended to decline gradually in turn (P<0\^001).The multivariate regression analysis revealed that the serum adiponectin was correla ted significantly with FBG,third-trimester weight and third-trimester BMI(r 2=0\^484,P<0\^001).Conclusion The serum adiponectin level in the GDM and GIGT patients decreases significantly ,especially in the GDM cases,and its change is significantly negatively associat ed with IR.