妊娠期糖代谢异常及糖尿病、心脑血管疾病家族史对新生儿脐静脉血C肽水平的影响

Influence of abnormal glucose metabolism during pregnancy and family history of cardio. cerebrovascular disease and/or diabetes on levels of C-peptide in umbilical vein

目的探讨孕妇妊娠期糖代谢异常及糖尿病、心脑血管疾病家族史对新生儿脐静脉血C肽水平的影响。方法选取85例孕妇及其新生儿作为研究对象，其中36例妊娠期糖尿病、妊娠期糖耐量减低及糖尿病合并妊娠的孕妇及其新生儿作为病例组；随机收集同期分娩的49例糖代谢正常孕妇及其新生儿作为对照组。每组又根据孕妇的父母是否具有糖尿病和／或心脑血管疾病家族史分为家族史阳性组与家族史阴性组。即将研究对象共分为四组：家族史阳性／病例组（A组）25例；家族史阴性／病例组（B组）11例；家族史阳性／对照组（C组）9例；家族史阴性／对照组（D组）40例。抽取四组新生儿的脐静脉血，分离血清。采用放射免疫法测定脐静脉血C肽水平，应用方差分析比较四组C肽水平。结果A组、B组、C组及D组新生儿脐静脉血C肽水平分别为（2．22±1．52）、（1．44±0．63）、（1．13±0．34）、（1．31±0．69）μg／L，A组新生儿脐静脉血C肽水平高于其他三组，差异有统计学意义（F=5．11，P=0．003）；而B组、C组及D组新生儿脐静脉血C肽水平两两比较差异无统计学意义，P值分别为0．499（B组与C组）、0．694（B组与D组）、0．642（C组与D组）。结论外祖父母患糖尿病和／或心脑血管疾病同时妊娠期存在糖代谢异常或糖尿病合并妊娠的孕妇，其新生儿脐静脉血C肽水平显著升高，应对其代谢状况予以密切随访。

Objective To estimate the influence of abnormal glucose metabolism during pregnancy and family history of cardio-cerebrovaseular disease and/or diabetes on umbilical C-peptide concentrations. Methods Chosed 85 pregnant women who had prenatal examination and their newborns as the subjects. Thirty-six newborns of mothers with gestational diabetes mellitus, impaired glucose tolerance or diabetes mellitus with pregnancy and 49 newborns of mothers with normal glucose tolerance were randomly chased as the control group. All newborns were also classified according to whether their maternal grandparents had history of diabetes and/or cardio-eerebrovascular disease. Therefore, there were four groups in this study： 25 newborns in group A were of diabetic mothers and positive family history, 11 newborns in group B were of diabetic mothers but negative family history, 9 newborns in group C were of mothers with normal glucose tolerance but positive family history, 40 newborns in group D were of mothers with normal glucose tolerance and negative family history. The blood samples of umbilical veins were collected at the time of delivery. Umbilical C-peptide levels of the four groups were measured by radioimmunoassay. Results The umbilical C-peptide concentrations of newborns in group A, B, C, D were （2.22± 1.52）, （1.44 ±0.63）, （1.13 ± 0.34）, （ 1.31 ±0.69 ） μ g/L respectively, the umbilical C-peptide concentrations of newborns in group A were elevated compared to those of other three groups （F = 5.11, P = 0.003）, and there were no significant differences in C-peptide levels of newborns between the three groups （group B vs C P = 0.499, group B vs D P = 0.694, group C vs D P = 0.642）. Conclusion Special attention should be given to newborns of diabetic mothers and whose maternal grandparents have history of diabetes and/or eardio-cerebrovascular disease.