妊娠期糖尿病瘦素与脂联素水平及干预变化

Levela of leptin and adiponectin and ehangos of intervention in patients with goatafional diabetes mellitua

目的探讨韶关市妊娠期糖尿病（GDM）的发病率、瘦素及脂联素水平及干预变化。方法采取分层整群随机抽样方法对韶关地区2006年1月至2010年12月确诊GDM患者262例及1508例正常孕妇的血清瘦素、脂联素水平进行分析，并比较193例单纯饮食控制及59例应用饮食控制加胰岛素治疗的GDM患者治疗前后瘦素、脂联素及糖化血红蛋白变化情况。结果GDM组患者的血清瘦素水平明显高于正常组（P〈0．05），而脂联素水平却明显低于正常组（P〈0．05）。193例单纯饮食控制的GDM患者治疗后糖化血红蛋白降低，血清瘦素水平降低，血清脂联素水平升高。59例应用饮食控制加胰岛素治疗的GDM患者治疗后糖化血红蛋白明显降低，血清瘦素及血清脂联素水平均升高。结论血清瘦素、脂联素与GDM的发生密切相关，结合两个指标，可以预测GDM的发生，饮食控制加胰岛素治疗可改善GDM患者的预后。

Objective To investigate the morbidity of gestational diabetes mellitus （ GDM ） and levels of leptin and adiponectin and changes of intervention in patients with GDM in Shaoguan. Methods Using strati-fled cluster random sampling method, analyzed the serum levels of leptin and adiponectin in 262 patients with GDM and 1508 healthy pregnant women in Shaoguan from January, 2006 to December, 2010. Changes of leptin, adiponectin, and glycosylated hemoglobin in 193 GDM patients accepting diet therapy and 59 ones treated with diet therapy and insulin were compared before and after the treatment. Results Serum level of leptin was markedly higher in GDM group than in healthy group （ P〈 0.05 ）, while adiponectin level was significantly lower （P〈 0.05 ）. Glycosylated hemoglobin and leptin levels became lower, but adiponectin level higher, in 193 GDM patients taking diet therapy; glycosylated level got obviously lower, but levels of leptin and adiponectin higher, in 59 ones treated with diet therapy and insulin. Conclusions Serum leptin and adiponectin closely correlate with the incidence of GDM. Combination detection of these two indicators can predict the occurrence of GDM. Diet therapy in combination with insulin can improve the prognosis of GDM patients.