网膜素在妊娠糖尿病患者中表达的临床意义

Clinical significance of the expression of omentin in the patients with gestational diabetes mellitus

目的探讨不同糖耐量孕妇血清网膜素表达的临床意义。方法选择88例糖代谢异常孕妇及72例正常孕妇(NGT)。根据OGTT试验及治疗情况将糖代谢异常孕妇分为妊娠糖尿病(GDM)A1级组54例、GDMA2组34例。测定3组空腹血糖(FBG)、胰岛素(FINS)、网膜素及TNF-α浓度,计算出胰岛素抵抗指数(HOMA-IR),比较3组妊娠结局。结果 GDMA2组显示出更高的母儿并发症(P<0.05);相比NGT组,GDMA1组HOMA-IR升高及网膜素降低(P均<0.05),GDMA2组FBG、HOMA-IR、FINS及TNF-α均显著升高,而网膜素水平进一步降低(P<0.01);所有患者血清网膜素与HOMA-IR呈负相关(r=-0.819,P<0.01);而在GDMA2组血清网膜素还与FINS、TNF-α呈负相关(r=-0.723,P<0.01;r=-0.682,P<0.01)。结论网膜素可能是一个敏感的GDM的诊断指标,GDM中的高胰岛素抵抗状态可能是引起网膜素升高的因素。

Objective It is to investigate the clinical significance of expression of serum omentin in patients with gestational diabetes mellitus（ GDM）. Methods 88 patients with GDM and 72 normal control（ NGT） were enrolled in this study. The patients were divided into 2 groups： GDMA1 group（ n = 54）,GDMA2 group（ n = 34） according to the OGTT test and their treatment. The levels of fasting blood glucose（ FBG）,fasting insulin（ FINS）,serum omentin,TNF- αwere determined and HOMA- IR were calculated. The pregnancy outcomes were compared in three groups. Results More complications were displayed in the GDMA2 group（ P 〈0. 05）; Compared to the NGT group,GDMA1 group showed a higher HOMA- IR and a lower serum omentin levels（ P 〈0. 05）. Moreover,some indexes,like FBG,HOMA- IR,FINS and TNF- α,were much higher in GDMA2 group,except a much lower serum omentin levels（ P 〈0. 01）; Serum omentin levels were negatively correlated with HOMA- IR among all patients（ r =- 0. 819,P〈 0. 01）; Subgroup analysis for GDMA2 group,serum omentin levels were also negatively correlated with FINS and TNF- α（ r =- 0. 723,r =- 0. 682,P〈 0. 01）. Conclusion Serum omentin might be a new and sensitive marker for diagnosing GDM; the decreased serum omentin might be due to the insulin resistance.