妊娠期糖尿病孕妇血清瘦素及内分泌激素测定的临床探讨

Clinical study on serum leptin levels and endocrine hormones in gestational diabetes mellitus.

目的研究妊娠期糖尿病患者血清瘦素与内分泌激素间的关系以及对胎儿生长发育的影响。方法采用放射免疫法测定妇女血清瘦素(Leptin),雌激素(E2),孕激素(PROG),胎盘泌乳素(HPL),C肽及胰岛素水平,新生儿抽取脐带血测定瘦素、胰岛素、C肽水平。结果(1)妊娠期糖尿病(GDM)组孕妇血清瘦素水平明显高于妊娠期糖耐量受损(IGT)组及正常妊娠组(P<0.01);GDM组新生儿脐带血瘦素水平明显低于正常妊娠组及IGT组新生儿脐血瘦素水平(P<0.01)。(2)正常妊娠组、IGT组和GDM组孕妇E2水平高于非妊娠组(P<0.01);各个妊娠组之间E2,HPL,P无显著性差异(P>0.05)。(3)正常妊娠组、GDM组孕妇血清瘦素水平与PROG有相关性(P<0.01,P<0.05);GDM,IGT孕妇血清瘦素水平与胎儿宫内窒息有相关性(P<0.05)。结论(1)妊娠期间瘦素与内分泌激素互相调节。(2)瘦素水平的升高参与了GDM的发病过程,瘦素可作为GDM围产期监护的指标之一。

Objective To investigate the relationship between serum leptin levels and endocrine hormones in patients who experienced gestational diabetes mellitus （GDM） , and its effect on fetal growth. Methods Serum leptin, E2, PROG, HPL, C-Peptide and insulin levels were determined by RIA. The leptin, insulin and C-peptide levels of newborn umbilical cord blood were determined by RIA as well.Results （1）Leptin levels in patients with GDM were significantly higher than GIGT and normal pregnancy group（P〈0.01）;Serum leptin levels of newborn were significantly lower than GIGT and normal pregnancy group（P〈0.01）. （2）E2 levels of normal pregnancy group, GIGT and GDM were higher than non-pregnant group（P〈0.O1）. （3）Serum leptin levels of normal pregnency group and GDM group correlated with PROG（P〈0.01, P〈0.05）;Serum leptin levels of GDM and GIGT correlated with asphyxia neonatorum（P〈0.01, P〈0.05）.Conclusion （1）There is mutual regulation of leptin and endorcrine hormones during pregnancy; （2）The increasing of serum leptin levels participates in the development of GDM, so the leptin can be taken as one of indexes during perinatal monitor for GDM.