妊娠期糖尿病患者血清中瘦素及其可溶性受体的变化及其与胰岛素抵抗、炎症反应的相关性研究

The change of serum leptin and its soluble receptor in patients with gestational diabetes mellitus as well as their correlation with insulin resistance and inflammatory response

目的:探讨妊娠期糖尿病(GDM)患者血清中瘦素及其可溶性受体的变化及其与胰岛素抵抗、炎症反应的相关性研究。方法:收集在本院进行分娩的GDM患者118例作为观察组,同期在本院进行分娩的糖代谢正常产妇60例作为正常对照组。测定两组产妇分娩前血清中瘦素及其可溶性受体的含量,外周血中胰岛素抵抗指标的水平,血清及胎盘组织中炎症反应指标的含量,进一步采用Pearson检验评估GDM患者血清Leptin、SLR含量与胰岛素抵抗、炎症反应的相关关系。结果:观察组产妇血清中Leptin的含量高于正常对照组产妇,SLR的含量低于正常对照组产妇;外周血中胰岛素抵抗指标FINS、HOMA-IR的水平显著高于正常对照组产妇,HOMA-β的水平低于正常对照组产妇;血清及胎盘组织中炎症反应指标IL-1β、IL-2、IL-6的含量均显著高于正常对照组产妇(P<0.05)。经Pearson检验发现,GDM患者血清中Leptin、SLR的含量与胰岛素抵抗、炎症反应程度直接相关。结论:GDM患者血清中Leptin、SLR表达异常且其异常程度与机体胰岛素抵抗、炎症反应程度直接相关。

Objective： To study the change of serum leptin and its soluble receptor in patients with gestational diabetes mellitus （GDM） as well as their correlation with insulin resistance and inflammatory response.Methods： A total of 118 patients with GDM who delivered in our hospital between June 2014 and November 2016 were collected as observation group, and 60 puerperae with normal glucose metabolism who delivered in our hospital during the same period were collected as normal control group.Before delivery, the contents of leptin and its soluble receptor in serum, the levels of insulin resistance indexes in peripheral blood and the contents of inflammation indexes in serum and placental tissue of two groups of puerperae were determined, and Pearson test was used to further evaluate the correlation of serum leptin and SLR levels with insulin resistance and inflammatory response in patients with GDM.Results： Serum leptin content of observation group was higher than that of normal control group while SLR content was lower than that of normal control group;insulin resistance indexes FINS and HOMA-IR levels in peripheral blood were significantly higher than those of normal control group while HOMA-β level was lower than that of normal control group;inflammatory response indexes IL-1β, IL-2 and IL-6 contents in serum and placental tissue were significantly higher than those of normal control group （P〈0.05）.Pearson test showed that serum leptin and SLR levels in patients with GDM were directly correlated with the degree of insulin resistance and inflammatory response.Conclusions： Serum leptin and SLR expression are abnormal in patients with GDM and the abnormal degree is directly correlated with the degree of insulin resistance and inflammatory response.