妊娠期糖尿病患者血糖、血脂、血浆脂蛋白及载脂蛋白水平测定

Detection of serum lipid, lipoprotein, and apolipoprotein in gestational diabetes mellitus patients with different glucose control levels

目的:探讨妊娠期糖尿病孕妇血糖控制水平与其血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、载脂蛋白A1、B(ApoA1、ApoB)水平变化的关系.方法:选择妊娠期糖尿病(GDM)孕妇30例,其中19例为血糖良好控制组,11例为血糖控制不良组,对照组正常孕妇30例(正常妊娠组).3组分别于孕32～36周抽取静脉血,测定空腹静脉血清TC、TG、HDL-C、LDL-C、VLDL-C、ApoA1及ApoB.结果:血糖良好控制组与对照组相比,各测定值差异均无统计学意义(P＞0.05);而血糖控制不良组与对照组相比,除TC外,各测定值均与对照组差异有统计学意义,TG、LDL-C、VLDL-C、ApoB均较对照组明显升高(P＜0.05),而HDL-C、ApoA1测定值较对照组显著降低(P＜0.05).结论:GDM患者,血糖控制在满意范围内,其血脂,血浆脂蛋白及载脂蛋白不会发生严重紊乱,对母体的健康不会产生严重的不利影响;反之,其血脂、血浆脂蛋白及载脂蛋白代谢将发生严重紊乱.

Aim: To study the changes of serum lipid, lipoprotein and apolipoprotein in gestational diabetes mellitus(GDM) women with different glucose control levels. Methods: The serum lipid, lipoprotein and apolipoprotein were measured in 30 women with GDM and 30 normal pregnant women.Thirty GDM women were allocated into well-controlled glucose group (19 cases) and poorly controlled glucose group (11 cases).Results: In GDM women with well-controlled glucose, serum lipids, apolipoproteins,and lipoproteins were similar to those of normal control. Serum triglyceride, very low density lipoprotein (VLDL), low density lipoprotein (LDL) , and apolipoprotein B (ApoB) were significantly higher, whereas serum ApoA1 and HDL were significantly lower in GDM women with poorly controlled glucose compared with the normal control. Conclusion: GDM women with well-controlled glucose have normal lipid metabolism. However,poorly controlled GDM women are associated with lipid, lipoprotein and apolipoprotein abnormalities.