妊娠糖尿病患者血清脂联素与炎症因子的关系及临床意义

Clinical Significance and Relationship of Serum Adiponectin with Inflammatory Factors in Gestational Diabetes Mellitus

目的检测妊娠糖尿病（GDM）患者血清脂联素（APN）与炎症因子IL-6，IL-17，D反应蛋白（CRP）的水平并分析其关系，探讨炎症因子在妊娠糖尿病发展进程中的作用。方法按照ADA诊断标准选取GDM组60例，妊娠糖耐量正常组（非GDM组）39倒，健康对照组（NGT组）45例。分别采用ELISA检测空腹血清APN，IL-6，IL-17，免疫比浊法测CRP水平。结果①与NGT组比较，非GDM组、GDM组APN水平明显下降（P〈0．05，P〈0．01），且GDM组较非GDM组下降更明显（P〈0．01），而CRP，IL-6，IL-17在非GDM组明显上升（P〈0．01，P〈0．01，P〈0．05），且GDM组较非GDM组明显升高，差异有统计学意义（P〈0．05，P〈0．05，P〈0．01）；②GDM患者妊娠中期与晚期比较，APN水平下降明显（P〈0．05），CRP，IL-6，IL-17明显上升（P〈0．01，P〈0．01，P〈0．01）；③相关性分析显示：APN与炎症因子CRP，IL-6，IL-17在GDM患者中晚期均呈负相关。结论脂联素与炎症因子的负相关，提示炎症与抗炎症失衡机制参与妊娠糖尿病的发生发展。

Objective Investigate the levels of serum adiponectin（APN） ,IL-6,IL-17,CRP among gestational diabetes mellitus （GDM） and healthy gestational women,and analyse their relationship,in addition explore the possible significaenee of adiponectin in the development of gestational diabetes mellitus. Methods To select 60 women with GDM, 39 healthy gesrational women,and 45 healthy women,all subjects were divided with ADA diagnosis standard. The APN and IL-6,IL-17 were detected with ELISA,and CRP with immunoturbidimetry. Results （1）Compared with NGT group,adiponectin in no- GDM and GDM group were significantly lower（P〈0. 05,P〈0. 01） ,and GDM group compared with the GDM group drop more obvious （P〈0. 01） ,but CRP,IL-6 and IL-17 were higher （P〈0.01 ,P〈0. 01 ,P〈0. 05） ;and GDM group compared with the no-GDM group increased significantly difference,with a statistical significance （P〈0. 05, P〈0. 05, P〈0. 01） ;（2） The serum APN level was lower in late generational of GDM than early generational of GDM （P〈0. 05）,but CRP,IL-6 and IL-17 were increased obviously（P〈0.01,P〈0.01,P〈0.01）. （3）Negative associations were found between APN and IL-6,IL-17 and CRP. Conclusion Significant negative correlation showed between adiponectin and inflammatory factors, this indicate that inflammation and anti-inflammatory imbalances mechanisms involved in women with gestational diabetes mellitus events.