脂肪代谢水平变化与妊娠期糖尿病发病的相关性分析

Correlation between the changes of lipid metabolism and the incidence of gestational diabetes

目的观察妊娠期糖尿病患者的脂代谢水平,并探讨其与妊娠期糖尿病发病的相关性。方法选取2016年2月—2017年6月在河北北方学院附属第二医院内分泌科接受治疗的妊娠期糖尿病患者60例为研究对象(观察组),同时选取同期在妇产科接受产前检查的健康妊娠期妇女60例作为对照(健康对照组)。观察2组患者脂代谢、血糖水平和细胞因子水平的差异,分析妊娠期糖尿病患者脂代谢与血糖水平和细胞因子水平的相关性。结果观察组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、内脂素水平高于健康对照组(t=-7.516、-5.323、-14.787、-86.705,P均<0.001),高密度脂蛋白胆固醇(HDL-C)、脂联素水平低于健康对照组(t=16.378、9.712,P<0.001);观察组患者的平均血糖(MBG)、血糖标准差(SDBG)、血糖波动频数(NEGE)、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))水平高于健康对照组(t=-23.372、-5.829、-5.702、-14.407、-14.147,P均<0.001);观察组患者的C反应蛋白(CRP)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平亦高于健康对照组(t=-17.384、-10.295、-14.072,P均<0.001);妊娠期糖尿病患者TC、LDL-C、TG、内脂素与MBG、SDBG、NEGE、FPG、HbA_(1c)、CRP、IL-6和TNF-α水平呈正相关,HDL-C、脂联素与MBG、SDBG、NEGE、CRP、IL-6和TNF-α水平呈负相关。结论妊娠期糖尿病患者的TC、LDL-C等脂代谢指标较高,且与血糖水平和细胞因子水平密切相关,可作为临床监测妊娠期糖尿病发病的重要指标。

Objective To observe the level of lipid metabolism in patients with gestational diabetes and to explore the correlation with the onset of gestational diabetes. Methods Pregnant women with gestational diabetes treated in department of endocrinology of Second Affiliated Hospital of Hebei North University from February 2016 to June 2017 were selected as the research objects （60 cases）,and the healthy pregnant women who received the antenatal examination were selected as the control group （60 cases）. The differences of lipid metabolism,blood glucose level and cytokine levels between the two groups were observed,and the correlation among lipid metabolism, blood glucose level and cytokine levels in gestational diabetes mellitus was analyzed. Results The levels of TC, LDL-C, TG and visfatin in the observation group were higher than those in the control group （ t =-7.516, t =-5.323, t =-14.787, t =-86.705, all P 〈0.001）, and the levels of HDL-C and adiponectin were lower than those in the control group （ t =16.378, t =9.712, P 〈0.001）; The levels of MBG, SDBG, NEGE, FPG and HbA 1c in the observation group were higher than those of the control group （ t =-23.372, t =-5.829, t =-5.702, t =-14.407, t =-14.147, P 〈0.001）; The levels of CRP,IL-6 and TNF-alpha in the observation group were higher than those in the control group （ t =-17.384, t =-10.295, t =-14.072, P 〈0.001）; The levels of TC,LDL-C,TG and visfatin in gestational diabetes mellitus were positively correlated with MBG, SDBG, NEGE, FBP, HbA 1c , CRP, IL-6 and TNF-alpha level. Conclusion The TC, LDL-C and other lipid metabolism indexes are higher in gestational diabetes mellitus patients, and are closely related to blood glucose levels and cytokines levels, which can be used as an important index for clinical monitoring of the onset of gestational diabetes.