妊娠期糖尿病高龄产妇血清脂联素水平与胰岛素抵抗的相关性研究

Relationship between serum adiponectin concentration and insulin resistance in elderly pregnancy patients with gestational diabetes mellitus

目的探讨妊娠期糖尿病（gestational diabetes mellitus,GDM）高龄产妇血清脂联素（adiponectin,APN）水平与胰岛素抵抗（insulin resistance,IR）的相关性，为临床治疗提供参考。方法回顾性分析浙江省温州市中心医院妇产科2011年1月至2016年12月期间诊治的GDM高龄产妇临床资料，分析患者血清APN水平及IR的相关性。以本院同期健康产妇体检者（对照组）和正常妊娠产妇（正常妊娠组）为对照。结果GDM高龄产妇患者血清中APN、明显低于对照组和正常妊娠组，而稳态模型评估的胰岛素抵抗指数（homeostasis model assessment of insulin resistance,HOMA-IR）、白细胞介素2（interleukin-2,IL-2）、IL-12、IL-18、胱抑素C（cystatin C,CysC）、脑钠肽（brain natriuretic peptide,BNP）及BNP前体、胰岛素样生长因子（insulin-like growth factor,IGF）1、IGF2及IGFIR水平明显高于对照组和正常妊娠组研究对象，且差异存在明显的统计学意义（P〈0.05）；Spearman相关性分析发现GDM高龄产妇患者血清APN与IR及细胞因子水平呈明显的相关性：随着GDM高龄产妇APN水平的降低，内脂素水平、其他因子水平和IR系数明显升高（P〈0.05）。结论GDM高龄产妇血清APN与IR具有明显的负相关性。

ObjectiveTo explore the relationship between serum adiponectin （APN） concentration and insulin resistance （IR） in elderly pregnancy patients （GDM） with gestational diabetes mellitus. MethodsData of 120 cases of elderly pregnancy patients with gestational diabetes mellitus admitted from Jan. 2011 to Dec. 2016 were retrospective analyzed. The relationship between serum APN concentration and IR was assayed. Healthy subjects and normal pregnancy patients in our Department were taken as the control. ResultsThe concentration of APN was lower while the CysC, BNP, IGF1, IGF2 and IGFIR were higher in elderly pregnancy patients with gestational diabetes mellitus than those in the control group with a significant difference （P〈0.05） . At the same time, Spearman analysis results showed that the serum APN was negatively related with IR while CysC, BNP, IGF1, IGF2 and IGFIR were positively related with IR （P〈0.05） . ConclusionThe serum concentration of adiponectin and visfatin were negatively related with insulin resistance in elderly pregnancy patients with GDM.