脂肪细胞因子和C反应蛋白在妊娠期糖尿病患者血清中的水平及其临床意义

The levels and clinical significance of serum chemerin and CRP in patients with gestational diabetes mellitus

目的探讨脂肪细胞因子(chemerin)和C反应蛋白(CRP)在妊娠期糖尿病(GDM)患者血清中的水平及其临床意义。方法选取2015年5月~2017年5月在东营市第二人民医院产科诊断为GDM的35例产妇作为糖尿病组,同期选取年龄、孕周、孕前体质量指数等指标与糖尿病组相匹配的孕妇45例为正常对照组,检测两组孕妇血清chemerin与CRP水平,并同时测定空腹血糖(FPG)、空腹胰岛素(Fins)、三酰甘油(TG)、糖化血红蛋白(Hb A1c)、胰岛素抵抗(HOMA-IR)、白细胞(WBC)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)等指标,比较两组的差异,进一步分析血清chemerin与CRP与各指标的相关性。结果两组患者比较,糖尿病组的血清chemerin、CRP、FPG、Fins、TG、Hb A1c、HOMA-IR、WBC均高于正常对照组,差异有统计学意义(P<0.05);而两组间TC、LDL-C水平差异无统计学意义(P>0.05)。Pearson线性相关分析显示,血清chemerin水平与TG、HOMA-IR呈正相关(r分别为0.574,0.412,P分别为0.014,0.011);血清CRP与FPG正相关(r=0.452,P=0.035)。结论血清chemerin和CRP可能与调节脂肪细胞生成、胰岛素抵抗等机制有关,进而参与GDM的发生、发展。

Objective To analyse the levels and the clinical significance of serum chemerin and CRP in patients with gestational diabetes mellitus. Methods Thirty-five cases of patients with gestational diabetes mellitus were selected as the GDM group. In addition, 45 cases of pregnant women with similar ages, gestational ages and body mass indexes in progestation to the GDM group were selected as the control group. The levels of serum chemerin and the levels of FPG, Fins,TG,HbA1c,HOMA-IR,WBC, TC,and LDL-C CRP were detected in the two groups; the differences between the two groups were compared, and the correlations between serum chemerin and CRP and the various indicators were further analysed. Results The levels of serum chemerin and CRP in the GDM group were higher than in the control group, and the differences were statistically significant （P 〈 0.05）. The levels of FPG,Fins,TG,HbA1c,HOMA-IR,WBC,and TC in the GDM group were higher than in the control group, and these differences were also statistically significant （P〈0.05）, but no significant differences were observed in the levels of TC and LDL-C between the two groups （P 〉 0.05）. The Pearson linear correlation analysis showed that the serum chemerin level was positively correlated with HOMA-IR and TG （r=0.574,0.412,P=0.014,0.011）and that the serum CRP was positively correlated with FPG （r=0.452,P=0.035）. Conclusion The serum levels of chemerin and CRP may be related to the regulation of adipocyte formation and insulin resistance and may participate in the development of GDM.