妊娠糖尿病孕妇血清视黄醇结合蛋白4、瘦素、人新饱食分子蛋白-1水平与血糖、胰岛功能的相关性研究

Correlation between levels of serum retinol binding protein 4,leptin,nesfatin-1 and blood glucose and islet function in gestational diabetes mellitus pregnant women

目的探究妊娠糖尿病(gestational diabetes mellitus,GDM)孕妇血清视黄醇结合蛋白4(retinol binding protein 4,RBP4)、瘦素、人新饱食分子蛋白-1水平变化及其与血糖、胰岛功能的相关性。方法选取2016年3月至2018年3月陆军军医大学第二附属医院收治的60例GDM孕妇为研究对象并纳入GDM组,选取同期于该院产检的90例健康孕妇纳入对照组。比较两组孕妇空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin A_(1c),HbA_(1c))、空腹血清胰岛素(fasting insulin,FINS)、稳态模型评估的胰岛素抵抗(homeostasis model assessment of insulin resistance,HOMA-IR)指数、RBP4、瘦素、人新饱食分子蛋白-1水平变化及并发症发生情况,分析GDM组孕妇血清RBP4、瘦素、人新饱食分子蛋白-1水平与血糖和胰岛功能的相关性。结果GDM组孕妇FPG、HbA_(lc)、血清RBP4、瘦素、人新饱食分子蛋白-1水平、HOMA-IR指数均显著高于对照组(均P<0.001),FINS水平显著低于对照组(P<0.001);GDM孕妇血清RBP4、瘦素、人新饱食分子蛋白-1水平与FPG、HbA_(lc)水平及HOMA-IR指数均呈正相关(均P<0.05),与FINS均呈负相关(均P<0.05);GDM组孕妇围产期羊水过多、胎膜早破、早产、剖宫产和产褥病发生率均显著高于对照组(均P<0.05)。结论血清RBP4、瘦素和人新饱食分子蛋白-1水平与GDM孕妇血糖代谢、胰岛功能密切相关,临床应密切监测GDM孕妇血清RBP4、瘦素和人新饱食分子蛋白-1水平,以防治GDM和孕妇围产期并发症的发生。

Objective To investigate the changes of levels of serum retinol binding protein 4(RBP4),leptin and human nesfatin-1 in pregnant women with gestational diabetes mellitus(GDM)and their correlation with blood glucose and islet function.Method 60 pregnant women with GDM who were admitted to the Second Affiliated Hospital,Army Medical University from March 2016 to March 2018 were selected as GDM group,and 90 healthy pregnant women who received antenatal care in that hospital during the same time were selected as control group.The levels of fasting plasma glucose(FPG),glycosylated hemoglobin A1c(HbA1c)and serum fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)index,changes of serum RBP4,leptin and nesfatin-1 levels and incidence of complications were compared between the two groups.The correlation of serum RBP4,leptin,nesfatin-1 and blood glucose levels with pancreatic islet function in pregnant women with GDM were analyzed.Result The FPG,HbAlc,serum RBP4,leptin and nesfatin-1 levels and HOMA-IR in GDM group were significantly higher than those in control group(all P<0.001),and the FINS level was significantly lower than that in control group(all P<0.001).Serum RBP4,leptin and nesfatin-1 levels in GDM group were positively correlated with FPG,HbAlc and HOMA-IR index(all P<0.05),and negatively correlated with FINS(all P<0.05).The incidence rates of polyhydramnios,premature rupture of membranes,premature delivery,cesarean section and puerperal diseases in GDM group were significantly higher than those in control group(all P<0.05).Conclusion Serum RBP4,leptin and nesfatin-1 levels are closely related to GDM pregnant women's blood glucose metabolism and islet function.Serum RBP4,leptin and nesfatin-1 levels should be closely monitored clinically to prevent GDM and perinatal complications in pregnant women.