妊娠期糖尿病患者血清Vaspin水平与胰岛素抵抗的相关性研究

The relationship between serum vaspin levels and insulin resistance in patients with gestational diabetes mellitus

目的探讨GDM患者血清Vaspin水平与IR的关系。方法选取2013年4～10月于我院产科行常规产前检查的孕妇176名,按75 g OGTT结果分为GDM组84例和糖耐量正常妊娠组（GNGT）92名,同时选取糖耐量正常未孕（NGT）者80名。检测各组血清Vaspin、瘦素（Leptin）、APN水平。行OGTT后检测各时点血糖、胰岛素、HbA1c和血脂水平,稳态模型评估胰岛素抵抗指数（HOMAIR）。结果与NGT组比较,GDM组和GNGT组Vaspin水平升高,且GDM组较GNGT组高[（2.72±2.20）vs（1.84±1.57）ng/ml,P〈0.05]。Pearson相关分析显示,GDM组Vaspin与HOMA-IR、TG呈正相关（r=0.387、0.218,P〈0.05或P〈0.01）。多元逐步回归分析显示,GDM组BMI-2（入组时BMI）、Vaspin、Leptin与HOMA-IR独立相关。二元Logistic回归分析表明,Vaspin和HOMA-IR是GDM的影响因素。结论 GDM患者Vaspin水平与IR相关,可能在GDM的发病机制中发挥重要作用,亦是GDM患者IS的重要标志。

Objective To investigate the association between serum vaspin levels and insulin resistance in gestational diabetes mellitus（GDM）.Methods A total of 256 individuals,including pregnant women with GDM（GDM group,n=84）,those without GDM（GNGT group,n=92）,and agematched healthy non-pregnant women（NGT,n=80）were enrolled in this case-control study.The levels of vaspin,leptin,adiponectin,glucose,insulin,hemoglobin A1c（HbA1c）and lipid parameters were measured.The homeostasis model assessment-insulin resistance（HOMA-IR）and other indexes were calculated.Results Compared with NGT group,serum vaspin levels were significantly higher in patients with GDM and GNGT.The levels of serum vaspin was also higher in GDM group than that in GNGT group[（2.72±2.20）vs（1.84±1.57）ng/ml,P〈0.05）].Serum vaspin level was positively correlated with HOMA-IR（r=0.387,P〈0.01）,and TG（r=0.218,P〈0.05）in GDM group.Multiple linear regression analysis showed that HOMA-IR was independently associated with BMI-2,vaspin and leptin in GDM.Similarly,logistic regression analysis showed that vaspin and HOMA-IR were independently associated with GDM.Conclusion The positive correlation between serum vaspin and insulin resistance in GDM may be involved in the pathogenesis of GDM and may become an important indicator of insulin sensitivity in patients with GDM.