脐血脂联素与妊娠期糖尿病巨大儿发生关系的研究

Study on the relationship between adiponectin in umbilical blood and the occurrence of macrosomia born by the women with gestational diabetes mellitus

目的:探讨脐血脂联素水平与妊娠期糖尿病巨大儿发生的关系。方法:选择孕期诊为GDM并且血糖控制满意的孕妇236例作为研究组,同期正常妊娠的孕妇251例作为对照组,追踪所有孕妇分娩的新生儿体重,新生儿出生体重≥4.0 kg为巨大儿。所有新生儿出生后即抽取脐血测脂联素水平,并记录出生体重、身长、肩围及腹壁皮下脂肪厚度,计算胰岛素抵抗指数HOMA-IR和新生儿营养指数RI。结果:GDM组巨大儿出生体重、RI及HOMA-IR均高于正常对照组巨大儿,差异有统计学意义(P<0.05),GDM组脐血脂联素水平明显低于对照组(P<0.05)。GDM组巨大儿脐血脂联素与出生体重、RI成负相关关系(P<0.05),与HOMA-IR成正相关关系(P<0.05),而与巨大儿身长、头围、肩围及腹壁皮下脂肪厚度不相关(P>0.05)。结论:脐血脂联素与胎儿宫内生长发育关系密切,脐血APN水平可直接反映巨大儿的体脂含量。

Objective： To explore the relationship between the level of adiponectin in umbilical blood and the occurrence of macro- somia born by the women with gestational diabetes mellitus （GDM） , Methods： A total of 236 pregnant women who were diagnosed as GDM and whose blood glucose was well controlled were selected as study group, and 251 normal pregnant women during the same period were se- lected as control group, the body weights of neonates born by the women in the two groups were followed up, the criterion of macrosomia was neonatal birth weight~〉4. 0 kg. The umbilical blood samples of all the neonates were abstracted to detect the levels of adiponectin, the birth weight, body height, shoulder circumference, subcutaneous fat thickness of abdominal wall were recorded; insulin resistance index （HOMA - IR） and neonatal nutrient index were calculated. Results： The birth weight, nutrient index, and HOMA - IR in GDM group were statisti- cally significantly higher than those in normal control group （ P 〈 0. 05 ） . The level of adipouectin in umbilical blood in GDM group was sta- tistically significantly lower than that in control group （ P 〈 0. 05 ） . There was a negative correlation between adiponectin level in umbilical blood and birth weight, and nutrient index in GDM group （ P 〈 0.05 ）, adiponectin level in umbilical blood was positively correlated with HOMA - IR （P 〈 0. 05 ） , there was no correlation between adiponectin level in umbilical blood and body length, head circumference, shoul- der circumference, and subcutaneous fat thickness of abdominal wall （P 〉 0, 05） . Conclusion： Adiponectin in umbilical blood was closely related to fetal intrauterine growth and development, which can reflect body lipid content of macrosomia.