妊娠肥胖、妊娠期糖尿病孕妇网膜素水平变化

Serum omentin levels in pregnancy obese subjects,GDM and relationships between serum omentin and other adipocytokines

目的探讨妊娠肥胖、妊娠期糖尿病(GDM)患者血清网膜素(Omentin)水平变化及其与脂联素(APN)、视黄醇结合蛋白-4(RBP-4)的相关性。方法采用酶联免疫吸附法检测38例孕前肥胖的GDM孕妇(A组)、41例孕前非肥胖的GDM孕妇(B组)、39例单纯肥胖孕妇(C组)、44例正常健康孕妇(D组)血清omentin、APN、RBP-4水平;同时测定所有受试者的糖、脂生化指标,并计算胰岛素抵抗指数(HOMA-IR)。结果 (1)GDM孕妇TG、FPG、FINS、HOMA-IR水平均高于正常对照组,HDL-C水平低于正常对照组(P<0.05)。A、C组孕妇FINS、HOMA-IR水平分别较B、D组高(P<0.05)。(2)GDM孕妇omentin、APN水平低于非GDM孕妇(P<0.001),C组孕妇omentin、APN水平低于D组孕妇(P<0.01);A组RBP-4水平最高(P<0.05),C组RBP-4水平高于D组(P<0.001)。(3)血清网膜素水平与HDL-C、APN正相关,与TG、FPG、FINS、HOMA-IR及RBP-4负相关(P<0.05)。(4)多元逐步回归分析显示FINS、APN是影响血清网膜素水平的重要因素(P<0.05)。结论 GDM孕妇及单纯肥胖孕妇存在糖、脂代谢异常,其血清omentin、APN水平降低,RBP-4水平升高,网膜素与糖、脂代谢指标及其他脂肪因子之间密切相关,共同参与肥胖及GDM的发生。

Objective： To investigate the change of serum omentin levels and the relationships between serum omentin and other adipocytokines in pregnancy obese subjects and GDM. Methods： Serum omentin, APN, RBP -4 levels were measured by Enzyme - Linked Immuno Sorbent Assay （ELISA） in 38 cases of GDM with obesity （Group A）, 41 cases of GDM with normal weight （Group B）, 39 cases of obesity pregnant women without pregnancy complications （ Group C）, and 44 cases of normal weight pregnant women （ Group D）. Meanwhile, FINS, FPG, TC, TG, HDL - C, LDL - C were measured. Insulin resistance was estimated using the homeostatic model assessment- insulin resistance （HOMA- IR） index. Results： （1） TG, FPG, FINS levels and HOMA -IR in GDM were higher and HDL - C levels were lower than those in the control group （P 〈 0. 05）. FINS, HOMA - IR levels were higher in the group A, C than those in the group B, D respectively （P 〈 0. 05）. （2） Serum omentin, APN levels in GDM were lower than those in non - GDM group （ P 〈 0. 001 ）. Serum omentin, APN levels in the group C were lower than those in the group D （P 〈 0.01 ）. Serum RBP - 4 levels were the highest in the group A （ P 〈 0. 05 ）. Serum RBP - 4 levels in the group C were higher than those in the group D （P 〈 0. 001 ）. （3） Positive correlation was shown between omentin levels and HDL - C, APN. There was significant negative correlation between omentin levels and TG, FPG, FINS, HOMA - IR, and RBP -4 （P 〈0. 05）. （4） In a multiple stepwise regression analysis, FINs, APN were independent variables of omentin. （ P 〈 0. 05）. Conclusion ： Pregnancy women with GDM and obesity were characterized by glucose, lipid metabolic disturbance. Serum omentin and APN levels were decreased and serum RBP -4 levels were increased in the GDM and the pregnancy obese subjects. Serum omentin levels were closely related with glucose, lipid metabolic indi- cators and other adipocytokines. Interactions between adipocytokines may be involved in the pathogenesis of obesity and GDM.