妊娠期糖尿病患者脐血瘦素/母血瘦素水平及新生儿出生体重的关系

The study of the relationship between cord leptin and mother′s leptin and neonatal birth weight in gestational diabetes

目的 探讨妊娠期糖尿病（gestational diabetes mellitus,GDM ）患者母血瘦素、脐血瘦素水平及其与新生儿体重的关系.方法 采用酶联免疫法测定40例GDM患者（GDM组）与40例正常孕妇（对照组）血清、脐静脉血清瘦素、胰岛素水平,同时测身高、体重计算体重指数,记录新生儿出生体重.结果 GDM组患者母血瘦素及胰岛素水平均高于对照组（P〈0.01,P〈0.05）;并且GDM组母血瘦素与其胰岛素呈正相关（r=0.57,P〈0.01）.GDM 患者和对照组母血瘦素水平明显高于脐血瘦素,但两者无相关关系;GDM组患者脐血瘦素、胰岛素水平明显高于对照组（P〈0.01,P〈0.05）;GDM组脐血瘦素与胰岛素水平、新生儿出生体重呈正相关（r＝0.39,P〈0.05;r＝0.49,P〈0.01）.本研究未发现孕妇血瘦素与新生儿出生体重有相关关系.结论 妊娠期糖尿病母儿同时存在高瘦素血症和高胰岛素血症,高瘦素状态与其发病有重要关系.

Objective To investigate the relationship between the levels of leptin in the umbilical blood and in ma- ternal serum of gestational diabetes mellitus （ GDM ） and body weight of the neonates. Methods Leptin and insulin in peripheral serum and umbilical veins were measured in 40 GDM cases and in 40 normal pregnancy cases by enzyme - linked immunosorbent assay（ELISA）. Meanwhile height, weight, body mass index were measured and calculated, neo- natal birth weight were recorded. Results Leptin in peripheral serum and umbilical veins and insulin level were higher in GDM than in normal pregnancy （ P 〈0.01 ,P 〈0.05 ） ;The level of leptin in maternal serum of GDM was positively re- lated to insulin level in maternal serum（ r = 0. 57 ,P 〈 0.01 ）. The levels of leptin in peripheral serum of GDM and in nor- mal pregnancy were higher than leptin level of umbilical veins. They were not related. The levels of leptin and insulin in the umbilical blood in GDM group were higher than in normal pregnancy（ P 〈 0. 01, P 〈 0.05 ） ;The levels of leptin in umbilical veins and insulin level in GDM were positively correlated（ r = 0. 39 ,P 〈 0.05）. The leptin level in the umbili- cal blood of GDM was positively related to infant birth weight （ r = 0. 49, P 〈 0.01 ）. Conclusion The levels of leptin and insulin of mother and fetus are significantly higher in GDM, high leptin level may contribute to the progress of GDM.