血清可溶性瘦素受体浓度与妊娠期糖尿病的相关性研究

Correlation between serum soluble leptin receptor level and gestational diabetes mellitus

目的探索正常妊娠、妊娠期糖尿病（GDM）孕妇不同孕期血清可溶性瘦素受体（sLR）浓度变化特点及其与GDM发病的相关性。方法随机选取2012年6月-2013年2月第三军医大学新桥医院就诊的正常妊娠孕妇300例（A组）、GDM孕妇60例（B组）及健康未孕妇女20例（C组），A、B组根据孕周分为3个亚组：孕14～19周（A1，n=100；B1，n=20）、30～34周（A2，n=100；B2，r／=20）、足月孕分娩前（≥37周）组（A3，n=100；B3，n=20）。采用酶联免疫吸附双抗体夹心法（ELISA法）分别检测各组血清sLR浓度，分析各组间及组内sLR浓度变化特点及其与GDM的关系。结果未孕组血清sLR浓度为4．095±0．996ng／ml，正常妊娠组中孕14～19周、孕30—34周、足月孕分娩前血清sLR浓度分别为7．091±4．039、8．543±5．460、10．130±7．069ng／ml，均显著高于未孕组，差异有统计学意义（P〈o．05），且正常妊娠组内各亚组间比较差异均有统计学意义（p〈o．05），即随着妊娠进展，血清sLR浓度逐渐升高。GDM组各孕期血清sLR浓度分别为4．582±1．333、5．863±2．682、5．584±3．914ng／ml，与正常妊娠相比均显著降低（P〈0．05），且GDM组内各亚组间比较差异均无统计学意义（P〉0．05）。在sLR浓度〈4．0、4．0～7．9、8．0～11．9、≥12．Ong／ml水平上，GDM例数及所占比例分别为29（48．3％）、20（33．3％）、9（15．0％）、2（3．3％），除4．0～7．9ng／ml与8．0～11．9ng／ml比较差异无统计学意义（p〉0．05）之外，其余两两比较差异均有统计学意义（P〈0．05），GDM比例随血清sLR浓度升高而降低。结论孕妇血清sLR浓度越低，GDM的发生率可能越高。

Objective To investigate the serum levels of soluble leptin receptor （sLR） in normal pregnant women and women with gestational diabetes mellitus （GDM） in gestational period, and the correlation between sLR and GDM. Methods Three hundred normal pregnant women （group A）, 60 pregnant women with GDM （group B）, and 20 healthy non-pregnant women （group C） were randomly selected from Jun. 2012 to Feb. 2013 in Xinqiao Hospital of Third Military Medical University. Group A and group B were respectively divided into 3 subgroups according to gestational ages： 14-19 weeks （A1, n=100; B1, n=20）, 30-34 weeks （A2, n=100; B2, n=20）, full-term before delivery （/〉 37weeks） （A3, n= 100; B3, n=20）. Serum sLR levels of all groups were determined by enzyme-linked immunosorbent assay （ELISA）, features of changes in sLR levels within and between groups were analyzed, and the correlation between serum sLR and GDM was analyzed. Results The serum sLR concentrations of normal pregnant women at three different gestational periods were 7.091±4.039, 8.543± 5.460 and 10.130± 7.069ng/ml, respectively, and they were much higher than that of non-pregnant women （4.095 ± 0.996ng/ml, P〈0.05）, and the differences among different gestational periods showed statistical significance （P〈0.05）. With the progression of the pregnant duration, the serum sLR levels of normal pregnant women increased dramatically. The serum sLR levels in women with GDM at three different gestational periods were 4.582 ± 1.333, 5.863 ±2.682 and 5.584 ± 3.914ng/ml, respectively, and they were much lower than those of normal pregnant women. However, no significant difference was found among the subgroups of group B （P〉0.05）. At four levels of sLR 〈4.0ng/ml, 4.0-7.9ng/ml, 8.0-11.9ng/ml and I〉 12.0ng/ml, the cases and proportion of GDM were 29（30.53%）, 20（15.63%）, 9（13.64%） and 2（2.82%）, significant differences were found between different sLR concentrations for proportion of GDM （P〈0.05） except between 4.0-7.9ng/ml and 8.0-11.9ng/ml （P〉0.05）. Conclusion Serum sLR level is negatively correlated with GDM, the lower the concentration of sLR, the higher the incidence of GDM.