妊娠期糖尿病产妇产后血清脂联素及C反应蛋白水平分析

An analysis of serum levels of adiponetin and C-reactive protein in parturients with gestational diabetes mellitus

目的分析妊娠期糖尿病(GDM)产妇产后6~8周的血清脂联素(APN)及C反应蛋白(CRP)水平。方法确诊GDM产妇61例,产后6~8周依据口服葡萄糖耐量试验(OGTT)分为糖耐量减低(A组,19例)和糖耐量恢复正常(B组,42例),另选20例正常妊娠产后6~8周产妇作为对照(C组),测定血清APN和CRP水平,比较三组稳态模型指数(HOMA-β)和HOMA-IR。结果A、B组APN低于C组,且A组亦低于B组(P<0.05)。A组空腹胰岛素(FIns)、CRP和HOMA-IR高于B、C组(P<0.05),而HOMA-β低于B、C组(P<0.05)。GDM产妇产后APN与孕晚期BMI、FIns、HOMA-IR呈负相关(r=-0.431、-0.187、-0.243,P<0.05),与HOMA-β呈正相关(r=0.325,P<0.01);CRP与FIns、HOMA-IR呈正相关(r=0.292、0.362,P<0.01)。结论GDM产妇产后糖代谢持续异常者的APN水平低于糖代谢恢复正常者,而CRP水平高于糖代谢恢复正常者。APN及CRP是反映GDM产妇产后糖代谢状态的敏感指标。

Objective To analyze serum levels of adiponetin （APN） and C-reactive protein （CRP） in 6 to 8 weeks after delivery in the parturients with gestational diabetes mellitus（GDM）. Methods Oral glucose tolerance test（OGTT） was carried out in 6 to 8 weeks after delivery in 61 parturients with GDM, who were assigned into two groups of A（with reduced glucose tolerance, 19 cases） and B（with normal glucose tolerance, 42 cases）. Another 20 parturients without GDM during pregnancy were taken as the controls （group C）. Serum levels of APN and CRP were measured, and the steady state model index（HOMA-13） and insulin resistance index（HOMA-IR） were compared. Results Serum level of APN was lower in groups of A and B than that in group C, which was lower in group A than that in group B（P〈0. 05）. The levels of fasting insulin（Fins）, CRP and HOMAqR were higher, but HOMA-β was lower, in group A than those in groups of B and C（P〈0. 05）. Serum APN level was negatively correlated with BMI in late pregnancy, Fins and HOMA-IR（r=- 0. 431, -0. 187, -0. 243, P〈0. 05） and positively correlated with HOMA-β （r = 0. 325, P〈0. 01 ）. Serum level of CRP was positively correlated with that of Fins and HOMA-IR（r=0. 292,0. 362,P〈0. 01）. Conclusion Serum level of APN is lower and CRP is higher in the GDM parturients with impaired glucose tolerance after delivery than those in those without. Serum levels of APN and CRP are the indicators reflecting glucose metabolic state in the GDM parturients after delivery.