GDM患者胎盘脂肪因子及炎症因子水平及与母体糖脂代谢相关性研究

Study on the correlation of the levels of placental adipocyte factors and inflammatory factors in GDM patients and maternal glucose and lipid metabolism

目的研究妊娠期糖尿病(GDM)患者的胎盘脂肪因子及炎症因子水平及与母体糖脂代谢相关性。方法研究对象选取枣阳市第一人民医院妇产科2015年12月至2017年1月间诊治的分娩GDM患者73例作为观察组,同期选择健康产妇60例作为对照组。检测两组孕妇的胎盘脂肪因子、炎症因子及母体糖代谢和脂代谢指标水平,同时比较两组孕妇的以上指标差异。结果观察组的胎盘组织中Leptin、Visfatin、RBP-4、Nesfatin-1及Chemerin水平均明显高于对照组,差异具有统计学意义(P<0.01),Adiponeetin明显低于对照组(P<0.01),NK-kB、IL-6、IL-8、IL-1β及TNF-α水平均明显高于对照组,差异具有统计学意义(P<0.01),FATP-4、FABP-1、FABP-3、FABP-4、FABP-5、EL及LPL均明显高于对照组(P<0.01);观察组的FBG、FINS及HOMA-IR均明显高于对照组,差异具有统计学意义(P<0.01),HOMA-β明显低于对照组,差异具有统计学意义(P<0.01),同时胎盘组织中IRS-1和IRS-2均明显低于对照组(P<0.01)。结论GDM患者糖脂代谢存在明显异常,同时胎盘组织中炎症因子和脂肪因子均呈现明显升高,且与糖脂代谢指标有着相关性,具有较高的临床指导价值。

Objective To study the correlation of the levels of placental adipocyte factors and inflammatory factors in patients with gestational diabetes mellitus(GDM)and maternal glucose and lipid metabolism.Methods 73 patients with GDM in our hospital from December 2015 to January 2017 were selected as the observation group,and 60 healthy pregnant women in the same period were selected as the control group.The levels of placental adipocyte factors and inflammatory factors and the maternal glucose and lipid metabolism levels were detected and compared in the two groups.Results The levels of Leptin,Visfatin,RBP-4,Nesfatin-1 and Chemerin in the placenta of the observation group were significantly higher than those in the control group(P<0.01);the levels of Adiponeetin were significantly lower than those of the control group(P<0.01);NK-kB,IL-6,IL-8,IL-1βand TNF-αlevels were significantly higher than those in the control group(P<0.01);the levels of FATP-4,FABP-1,FABP-3,FABP-4,FABP-5,EL and LPL were significantly higher than those in the control group(P<0.01).The levels of FBG,FINS and HOMA-IR in the observation group were significantly higher than those in the control group(P<0.01);HOMA-βlevel was significantly lower than that in the control group(P<0.01);the IRS-1 and IRS-2 levels in placenta were significantly lower than those in the control group(P<0.01).Conclusions GDM patients have abnormal glucose and lipid metabolism,and the levels of placental adipocyte factors and inflammatory factors increased significantly,with high correlation with glucose and lipid metabolism and clinical value.