妊娠糖尿病患者血清脂联素和TNF-α与胰岛素抵抗的关系

Relationship between the adiponectin and TNF-α with insulin resistance in patients with gestational diabetes mellitus

目的探讨妊娠期糖尿病(GDM)患者血清脂联素和肿瘤坏死因子α(TNF-α)水平与胰岛素抵抗(IR)关系。方法检测48例GDM患者(GDM组)、30例正常葡萄糖耐量妊娠者(NGT组)血清脂联素、TNF-α,分析两者与IR指数的相关性。结果与NGT组比较,GDM组血清脂联素水平下降(P<0.01),TNF-α升高(P<0.01)。脂联素与IR呈负相关(P<0.01),TNF-α与IR呈正相关(P<0.01)。体质量指数(BM I)、脂联素和TNF-α是影响GDM患者IR的独立危险因素。结论GDM患者血清低脂联素水平、高TNF-α水平与IR密切相关,是GDM发生发展的重要影响因素。

Objective To investigate the relationship between serum adiponectin and tumor necrosis factor-α（TNF-α） with the insulin resistance （IR） in the patients with gestational diabetes mellitus （GDM）. Methods Serum adiponectin and TNF-α were measured in 48 patients with GDM and 30 control subjects. Correlative analysis was carried out between the serum adiponectin, TNF-α and IR. Results Serum adiponectin was significantly lower（P 〈 0.01 ） in the patients with GDM than in control subjects. Serum TNF-α was significantly higher（ P 〈 0.01 ） in the patients with GDM. Serum adiponectin level was negatively correlative with IR（ r = -0.612 ,P 〈 0.01 ）. Serum TNF-α level was positively correlative with IR （r = 0.332,P 〈 0.01 ）. Multiple linear stepwise regression analysis indicated that body mass index （BMI）, adiponectin and TNF-α were independent factors affecting IR. Conclusion Low serum levels of adiponectin and high serum levels of TNF-α have positive relation with IR in patients with GDM, which may play an important role in the development of GDM.