妊娠期糖尿病孕妇血清淀粉样蛋白A水平与胰岛素抵抗及体重指数的关系

Relationship between serum amyloid A protein level and insulin resistance,body mass index among pregnant women with gestational diabetes mellitus

目的：探讨血清淀粉样蛋白A（SAA）在妊娠期糖尿病（GDM）患者血清中的表达情况,并分析其与胰岛素抵抗和孕妇体重指数（BMI）的关系。方法：选取2013年6月~12月在该院门诊产检并住院分娩的足月单胎孕妇60例,其中GDM孕妇30例为研究组,正常糖耐量孕妇30例为对照组。根据身高体重计算孕前及产前BMI,检测空腹血糖（FBG）、空腹胰岛素（FINS）、SAA及C反应蛋白（CRP）水平,计算胰岛素抵抗指数（HOMA-IR）;采用Pearson相关分析法对SAA与CRP、HOMA-IR及BMI进行相关性分析。结果：研究组FBG、FINS、HOMA-IR、SAA水平及产前BMI值均高于对照组,两组比较,差异均有统计学意义（P均〈0.05）。SAA与CRP、HOMA-IR、孕前及产前BMI呈正相关（r=0.436、0.479、0.432、0.552,P均〈0.05）。结论：SAA在GDM患者体内升高,与孕期肥胖相互作用,在GDM的形成中发挥着一定的作用,可导致糖代谢紊乱及胰岛细胞功能受损。因此,其可作为GDM的预测因子之一。

Objective： To explore the expression of serum amyloid A protein（ SAA） in pregnant women with gestational diabetes mellitus（ GDM）,analyze its relationship with insulin resistance（ IR） and body mass index（ BMI）. Methods： Sixty full- term pregnant women of single pregnancy who received prenatal examination in outpatient department of the hospital and gave birth to their babies in the hospital from June to December in 2013 were selected and divided into study group（ including 30 pregnant women with GDM） and control group（ including 30 pregnant women with normal glucose tolerance）. Progestational and prenatal BMI values were calculated according to body height and body weight; serum levels of fasting blood glucose（ FBG）,fasting insulin（ FINS）,SAA and C- reactive protein（ CRP）were detected; HOMA- IR was calculated. Pearson correlation analysis method was used to analyze the correlation between SAA and CRP,HOMA- IR,BMI. Results： Serum levels of FBG,FINS,HOMA- IR,SAA and prenatal BMI in study group were statistically significantly higher than those in control group（ P〈0. 05）. SAA was positively correlated with CRP,HOMA- IR,progestational and prenatal BMI values（ r = 0. 436,P〈0. 05; r = 0. 479,P〈0. 05; r = 0. 432,P〈0. 05; r = 0. 552,P〈0. 05）. Conclusion： SAA levels in GDM patients increase,interaction of SAA and gestational obesity plays a certain role in occurrence of GDM,which can induce glucose metabolic disorders and islet cell dysfunction. Thus,SAA can be used as one of predictive factors of GDM.