妊娠期糖尿病患者血清脂联素水平变化与胰岛素抵抗的关系

Maternal serum adiponectin concentration and correlation with insulin resistance in gestational diabetes mellitus

目的:探讨妊娠期糖尿病患者血清脂联素水平变化与胰岛素抵抗的关系。方法:测定30例妊娠期糖尿病患者(GDM组)、35例正常妊娠孕妇(NGT组)和15例非妊娠正常对照妇女(NC组)空腹血糖(FPG)、胰岛素(FINS)、C肽和血清脂联素水平,同时计算胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-HBCI),评价胰岛素抵抗程度和胰岛B细胞功能。结果:①血清脂联素水平从NC组[(10.10±2.05)mg/L]、NGT组[(7.78±1.67)mg/L]到GDM组[(4.74±1.45)mg/L]逐渐降低,差异有统计学意义(P<0.05);HOMA-IR从NC组、NGT组到GDM组逐渐升高,差异有统计学意义(P<0.05)。②血清脂联素与HOMA-IR、孕前BMI、胰岛素呈负相关(r分别为-0.560,-0.410和-0.465,P<0.05)。③GDM组较NGT组HOMA-HBCI显著降低,差异有统计学意义(P<0.05)。④多元回归分析提示HOMA-IR、FPG和孕前BMI是影响血清脂联素水平最显著的因素。结论:①GDM组较NGT组存在更为严重的胰岛素抵抗。②GDM组孕妇空腹血清脂联素水平降低与胰岛素抵抗有关。③胰岛B细胞功能缺陷在GDM的发病中起重要的作用。

Aim： To investigate serum concentration of adiponectin and its correlation with insulin resistance in pregnant women with gestational diabetes mellitus（ GDM ）. Methods：ELISA was used to measure serum adiponectin levels of 30 women with GDM ,55 cases of NGT women and 15 cases of healthy normal control. Insulin resistance index（HOMA-IR） and HOMA-HBCI was calculated. ResultS：（1）Levels of adiponectin decreased significantly from control subjects,NGT subjieets to GDM patients. Levels of HOMA-1R increased significantly from control subjects,NGT subjiects to GDM patients. （2）Serum adiponectin was negatively correlated with HOMA-IR and other corresponding parameters. （3）HBCI of GDM pa- tients was lower significantly than that of NGT and NC subjects. （4）The multivariate regression analysis revealed that HO- MA-IR,FPG were the most influential factors that affects adiponectin. Conclusion： （5）GDM patients involved more seriously insulin resistance. （6）Adiponectin may contribute to relieve insulin resistance of GDM patients. （7）The defect of function of B cell played the important role in the pathogenesis of GDM.