性激素结合球蛋白、胰岛素抵抗与妊娠期高血压疾病发病关系的探讨

Investigation of correlation between SHBG,IR and pathogenesis of pregnant hypertension

目的通过检测分析糖筛查正常的晚期妊娠孕妇血清中性激素结合球蛋白(SHBG)、空腹胰岛素水平、胰岛素抵抗指数的变化,评价胰岛素抵抗在妊娠期高血压疾病发病中的作用。方法电化学发光法测胰岛素水平,放免法测SHBG水平,采用稳态模式评估法测胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗。结果妊娠期高血压组和子痫前期组的空腹胰岛素水平、胰岛素抵抗指数均明显高于正常妊娠组,差异无统计学意义(P<0.05)。妊娠期高血压组的空腹胰岛素水平、胰岛素抵抗指数与子痫前期组相比,差异有统计学意义(P>0.05)。与妊娠期高血压组和子痫前期组相比,正常妊娠组的血清SHBG水平显著升高(P<0.05)。SHBG与胰岛素水平呈显著负相关(r=-0.566,P<0.05),与胰岛素抵抗指数呈显著负相关(r=-0.600,P<0.05)。结论妊娠期高血压、子痫前期患者较正常妊娠胰岛素水平升高,SHBG水平降低,胰岛素抵抗指数增加,胰岛素抵抗比正常妊娠明显。胰岛素抵抗与妊娠期高血压疾病有关。

Objective To evaluate the role of Insulin resistance （IR） in pregnant hypertension by detecting SHBG,blood sugar, fasting insulin levels and variation of IR index during the trimester gestation. Methods Insulin levels were detected by electronic chemical lighting method, and SHBG levels were measured by mdioimmunoassay, IR was measured by Homeostasis Model Assessment （HOMA）. Results Fasting insulin ievels and IR index in pre-eclampsia and gestatianal hypertension group were significantly higher than those of control group （P〈0.05）. There were no significant differences in fasting insulin levels and IR index between gestational hypertension group and pre-eclampsia group（P 〈0.05）. The serum SHBG levels in control group were significantly higher than those of gestational hypertension group and pre-eclampsia group（P〈0.05）. The SHBG levels were negatively correlated with the insulin levels and IR index （r=0.566, P〈0.05 ; r=0.600, P〈 0.05）. Conclusion As compared with those in control group, the Insulin levels in gestational hypertension group and pre-eclampsia group with normal blood sugar levels and glucose screening are increased, however, the SHBG levels are decreased, and the IR index is increased, especially in late pregnancy. IR is related with pregnant hypertension.