妊娠期糖尿病患者血清Nesfatin-1水平及糖脂代谢紊乱的相关性

Analysis of plasma Nesfatin-1 level and the correlation of Nesfatin-1 and metabolic disorders in glucos and lipid in pregnant women with GDM

目的探讨妊娠期糖尿病(GDM)患者血清中Nesfatin-1水平及糖脂代谢紊乱的相关性。方法 2013年1月至2014年1月妊娠中期(24-28w)诊断GDM的68例孕妇为GDM组,选取同期正常妊娠中期孕妇136例作为对照组。采用使用酶联免疫吸附法(ELISA)检测血清Nesfatin-1水平,检测总胆固醇(TC)、甘油三脂(TG)、载脂蛋白A(apo A)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、载脂蛋白A(apo A)、空腹血糖(FPG)、餐后1h血糖(1h PG)、餐后2h血糖(2h PG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR),比较两组的差异、分析血清Nesfatin-1与胰岛素抵抗相关性。结果 GDM组血清Nesfatin-1(0.98±0.54)(μg/L)、HDL-C(1.25±0.47)(mmol/L)明显低于对照组(1.54±0.38,P<0.01;1.36±0.29,P<0.05)。GDM组血清TG(2.91±0.93)(mmol/L)、LDL-C(2.93±0.76)(mmol/L)、apo A(1.54±0.21)(g/L)、FPG(5.32±0.62)(mmol/L)、2h PG(8.67±1.04)(mmol/L)、FINS(16.98±1.04)(m U/L)和HOMA-IR(4.52±0.64)均明显高于对照组[TG(2.59±0.61,P<0.05)(mmol/L)、LDL-C(2.68±0.59,P<0.01)(mmol/L)、apo A(0.86±0.37,P<0.01)(g/L)、FPG(4.35±0.41,P<0.01)(mmol/L)、2h PG(6.29±0.88,P<0.01)(mmol/L)、FINS(13.11±2.36,P<0.01)(m U/L)和HOMA-IR(2.47±0.28,P<0.01)]。相关性分析显示,GDM孕妇血清Nesfatin-1与TG、LDL、HDL、FPG、2h PG、FINS及HOMA-IR呈负相关(r=-0.557,P<0.01;r=-0.57,P<0.01;r=-0.63,P<0.01;r=-0.60,P<0.01;r=-0.71,P<0.01;r=-0.71,P<0.01;r=-0.68,P<0.01)。结论 GDM孕妇血清Nesfatin-1水平降低;Nesfatin-1降低与GDM糖脂代谢紊乱密切相关。

Objective：To investigate relationship between plasma Nesfatin-1 level and metabolic disorders in pregnant women with GDM. Methods：According the result of OGTT,the patients in second trimester were divided to two groups,GDM group（68 patients with GDM）and control group（136 healthy pregnant women）. The plasma levels of Nesfatin-1 were detected by ELISA. Meanwhile,TC,TG,apoA,LDL-C,HDL-C,apoA,FPG,1hPG,2hPG,FINS,HOMA-IR were measured,the difference of two groups were compared. The relationship between Nesfatin-1 and insulin resistence was analysed. Results：The plasma levels of Nesfatin-1（0.98±0.54）（μg/L）and HDL-C（1.25±0.47）（mmol/L）in the group of GDM were lower than those in control group（1.54±0.38,P〈0.01,P〈0.01;1.36±0.29,P〈0.05）. The plasma levels of TG（2.91±0.93）（mmol/L）,LDL-C（2.68±0.59）（mmol/L）,apoA（1.54±0.21）（g/L）,FPG（5.32±0.62）（mmol/L）,2hPG（8.67±1.04）（mmol/L）,FINS（16.98±1.04）（mU/L）and HOMA-IR（4.52±0.64）in the group of GDM were higher than those in control group [TG（2.59±0.61,P〈0.05）（mmol/L）,LDL-C（2.93±0.76,P〈0.01）（mmol/L）,apoA（0.86±0.37,P〈0.01）（g/L）,FPG 4.35±0.41,P〈0.01）（mmol/L）,2hPG（6.29±0.88,P〈0.01）（mmol/L）,FINS（13.11±2.36,P〈0.01）（mU/L）and HOMA-IR（2.47±0.28,P〈0.01）]. The correlation analysis shows that there is negative correlation between the serum level of Nesfatin-1 and TG,LDL,HDL,FPG,2hPG,FINS,HOMA-IR（r=-0.557,P〈0.01;r=-0.57,P〈0.01;r=-0.63,P〈0.01;r=-0.60,P〈0.01;r=-0.71,P〈0.01;r=-0.71,P〈0.01;r=-0.68,P〈0.01）in second trimester pregnant women with GDM. Conclusions：The plasma levels of Nesfatin-1 are lower in GDM group than in control group. Nesfatin-1 might play a key role in metabolic disorders in glucos and lipid in GDM.