脂联素和抵抗素与妊娠期糖尿病的相关性研究

Study on the Correlation of Serum Adiponectin and Resistin with Gestational Diabetes Mellitus Pregnant Women

目的探讨脂联素、抵抗素与妊娠期糖尿病的关系及其在妊娠期糖尿病发病中的作用;妊娠期糖尿病脂联素与抵抗素的相关性。方法选取产科门诊孕28～32周的孕妇,进行糖筛查(GCT)试验,异常者再行OGTT试验。按结果进行分组:正常糖代谢组(NGT)30例、糖耐量异常组(GIGT)21例、妊娠期糖尿病组(GDM)32例。利用Elisa方法测空腹脂联素和抵抗素,并测空腹血糖、空腹胰岛素。根据HOMA稳态模型提出的公式,计算胰岛素抵抗指数,分析各指标间的相关性。结果血清脂联素水平在NGT、GIGT、GDM3组的浓度是逐渐下降的,而抵抗素逐渐升高,在GDM组变化最明显(P<0.01)。相关分析发现,血清脂联素浓度与胰岛素抵抗指数、体质指数、空腹血糖和空腹胰岛素呈负相关(P<0.01),抵抗素与这些指标呈正相关(P<0.01),脂联素与抵抗素呈负相关(P<0.01)。结论脂联素是妊娠期糖尿病的保护因子之一;而抵抗素可促进妊娠期糖尿病的发生发展,增加胰岛素抵抗指数。提高患者血清中脂联素水平降低抵抗素水平,将来可能是治疗妊娠期糖尿病的新靶点。

Objective To investigate serum concentration of adiponectin and resistin and their correlation with insulin resistance in pregnant women with gestational diabetes mellitus （GDM）;To investigate the correlation between adiponectin and resistin of GDM.Methods 50-g glucose screening test was conducted for many cases pregnant women at 28～32 weeks of pregnancy.If the blood sugar value was abnormal to examine with oral glucose tolerance test （OGTT）.According to the result of OGTT,three groups were divided.The first group was 30 cases of normal glucose tolerance （NGT）,the second group was 21 cases of impaired glucose tolerance （GIGT）,the third group was 32 cases of gestational diabetes mellitus （GDM）.ELISA technique was employed to determine the serum adiponectin and resistin concentration,at the same time the fasting blood glucose,insulin concentration were detected.Insulin resistance index was calculated by HOMA,and the dependability of index was analyzed.Results （1） In the NGT,GIGT and GDM groups the serum adiponectin level tended to decrease gradually in turn（P 0.01）,but the level of serum resistin tended to advance gradually in turn（P 0.01）,especially in the GDM.（2） Serum adiponectin correlated negatively with insulin resistance index,fasting blood glucose and BMI（P 0.01）,whereas resistin correlated positively with the index above（P 0.01）,serum adiponectin correlated negatively with resistin of GDM（P 0.01）.Conclusion Adiponectin is one of the protection factors of GDM;resistin promotes the development of GDM by enhance insulin resistance index.It could be used as a new sensitive indicator to evaluate the degree of insulin resistance in GDM and it can be a new target of treatment of GDM.