瘦素、脂联素与妊娠期糖尿病胰岛素抵抗关系的研究

The study on the leptin and adiponectin and their correlation with isulin resistance in pregnant women with gestational diabetes mellitus.

目的探讨瘦素、脂联素与妊娠期糖尿病胰岛素抵抗的关系。方法采用稳态模型评估法评估正常糖耐量孕妇(NGT)糖耐量减低孕妇(GIGT)和妊娠期糖尿病孕妇(GDM)的胰岛素抵抗指数,采用放射免疫分析方法检测其血浆瘦素、脂联素、血糖及胰岛素水平。结果 GDM组和GIGT组HOMA-IR显著高于NGT组,GDM组HOMA-IR显著高于GIGT组。血清瘦素水平由NGT组到GIGT组和GDM组呈显著增高,瘦素与空腹胰岛素、孕晚期体重指数、HOMA-IR呈显著正相关;血清脂联素由NGT组到GIGT组和GDM组呈显著下降,脂联素与空腹胰岛素、孕晚期体重指数、HOMA-IR呈显著负相关。结论瘦素、脂联素水平与GDM患者IR程度密切相关,其水平可作为预测妊娠期糖尿病胰岛素敏感性的指标,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 leptin and their correlation with insulin resistance in pregnant women with gestational diabetes mellitus（GDM）.Methods：Homeoslasismodel as s essment（HOMA） was adopted to evaluate insulin resistance in the pregnancies with normal glucose tolerance（NGT）,impired glucose tolerance（GIGT） and gestational diabetes mellitus（GDM）.And radioimmunoassay was applied to detect the serum leptin,adiponectin insulin,glucose level in these three groups.Results：HOMA-IR in the GDM and GIGT group with the former higher than the later were significantly higher than those in the NGT group.In the NGT,GIGT and GDM group,the serum leptin level tended to increase grandually inturn.The leptin was postiviely correlated with FINS,third trimester weight,HOMA-IR.In the NGT,GIGT and GDM groups the serum adiponectin level tended to dicline gradually in turn especially in the GDM.Plasma adiponectin correlated negatively with insulin resistance index,fasting blood glucose BMI.Conclusion： The serum leptin and adiponectin level is significantly associated with the degree of insulin resistence of patients with GDM.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.