脂联素在妊娠糖尿病发病中的临床意义

Serum adiponectin changes and its role in women with gestational diabetes mellitus

目的探讨孕期脂联素(ADP)水平变化与妊娠糖尿病(GDM)血脂代谢指标及GDM发病的关系。方法选取GDM患者及正常对照组各60例,采用体外放射免疫分析方法测定其血清ADP、空腹胰岛素(FINS)水平,同时测定空腹血糖(FBG)、各项血脂水平总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C),计算稳态模型胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR),并测量身高、体质量,计算体质量指数(BMI)。结果血清ADP浓度在GDM组明显低于正常对照组,(5.8±0.6)mg/L vs(8.6±1.1)mg/L(P<0.01);GDM组的HOMA-IR、FINS、FBG、TG、LDL-C、TC均显著高于对照,5.4±1.2vs 2.8±0.7,(18.8±3.1)mU/L vs(13.6±2.2)mU/L,(6.5±0.9)mmol/L vs(4.6±0.7)mmol/L,(2.5±0.7)mmol/L vs(1.7±0.6)mmol/L,(3.2±0.7)mmol/L vs(2.3±0.5)mmol/L,(5.6±1.0)mmol/L vs(4.2±0.6)mmol/L。Pearson相关分析表明ADP水平与HOMA-IR、FBG、FINS及TG呈显著负相关。结论 ADP水平与胰岛素抵抗、高TG血症密切相关,低血清ADP水平参与了GDM的发生。

Objective To investigate the relation between serum adiponectin level,gestational diabetes mellitus（GDM） and blood lipid metabolism indices.Methods Radioimmunoassay was used to measure serum adiponectin levels of 60 woman with GDM and 60 cases of normal glucose tolerance group（NGT）.Insulin,serum glucose,lipid and insulin resistance index were also measured and calculated.Results The level of adiponectin was significantly decreased in GDM group compared with that of NGT group,（5.8±0.6） mg/L vs（8.6±1.1） mg/L（P〈0.01）.The levels of HOMA-IR,FINS,FBG,TG,LDL-C,TC were significantly increased in GDM group compared with those of NGT group,5.4±1.2 vs 2.8±0.7,（18.8±3.1） mU/L vs（13.6±2.2） mU/L,（6.5±0.9） mmol/L vs（4.6±0.7） mmol/L,（2.5±0.7） mmol/L vs（1.7±0.6） mmol/L,（3.2±0.7） mmol/L vs（2.3±0.5） mmol/L,（5.6±1.0） mmol/L vs（4.2±0.6） mmol/L.Significant negative correlation was found between the level of adiponcetin with HOMA-IR,FBG,FNS and TG.Conclusion Adiponectin plays an important role in monitoring the patients of GDM.Lower adiponectin is one of the main risk factors in predicting and screening of GDM.