血清中OPG、TNF⁃α和脂联素对妊娠期糖尿病的诊 断分析

Diagnostic analysis of serum OPG,TNF⁃αand adiponectin in gestational diabetes mellitus

目的探讨GDM孕妇血液循环中的OPG,TNF⁃α,脂联素和脂联素/TNF⁃α比值及其与代谢综合征生物标志物的关系和临床意义。方法使用酶联免疫吸附测定方法测量40名GDM妇女和40名健康孕妇血清中OPG,TNF⁃α和总脂联素的水平。分析OPG、TNF⁃α和脂联素与妊娠期糖尿病程度的相关性。结果两组资料比较显示,胎龄、BMI、TG、TC、LDL⁃C比较,差异无统计学意义(P>0.05);年龄、FBG、HDL⁃C、TG/TC、TC/HDL⁃C、LDL⁃C/HDL⁃C、AIP、胰岛素、HOMA⁃IR、QUICKI比较,差异有统计学意义(P<0.05)。GDM组的TNF⁃α表达水平高于NGT组;而OPG、脂联素和脂联素/TNF⁃α的比值显着低于NGT组,差异有统计学意义(P<0.05)。脂联素/TNF⁃α比值与胰岛素抵抗呈负相关(r=-0.68,P<0.05),甘油三酸酯(r=-0.39,P<0.05)与胰岛素敏感性呈正相关(r=0.69,P<0.05)。多元线性回归分析表明,脂联素/TNF⁃α比值与胰岛素抵抗独立相关。二元逻辑回归分析表明,GDM与OPG水平呈正相关,与脂联素/TNF⁃α比值呈负相关。结论GDM孕妇血液循环中的OPG水平升高而脂联素/TNF⁃α比值明显降低。该比率可能是评估孕妇胰岛素抵抗和血脂异常高风险以及GDM诊断和治疗监测目标的有效生物标志物。

Objective To explore OPG,TNF⁃α,adiponectin and adiponectin/TNF⁃αratio in the blood circulation of gestational diabetes mellitus(GDM)pregnant women and the relationship with metabolic syndrome biomarkers and clinical significance.Methods 40 women with GDM and 40 normal pregnant women were recruited in this study.The levels of serum OPG,TNF⁃αand total adiponectin were measured using enzyme⁃linked immunosorbent assay(ELISA).The correlation between OPG,TNF⁃αand adiponectin and the degree of GDM was analyzed.Results There was no statistically significant difference in gestational age,BMI,TG,TC,LDL⁃C(P>0.05).The age of pregnant women,FBG,HDL⁃C,TG/TC,TC/HDL⁃C,LDL⁃C/HDL⁃C,AIP,insulin,HOMA⁃IR,and QUICKI were was statistically significant between two groups(P<0.05).The expression level of TNF⁃αin the GDM group was higher than that in the control group.The ratio of OPG,adiponectin and adiponectin/TNF⁃αwas significantly lower than that in the control group(P<0.05).Adiponectin/TNF⁃αratio was negatively correlated with insulin resistance(r=-0.68,P<0.05).Triglycerides(r=-0.39,P<0.05)were positively correlated with insulin sensitivity(r=0.69,P<0.05).Multiple linear regression analysis showed that the adiponectin/TNF⁃αratio was independently related to insulin resistance.Binary logistic regression analysis indicated that GDM was positively correlated with OPG levels and negatively correlated with adiponectin/TNF⁃αratio.Conclusion the OPG level in the GDM groupincreased,while the adiponectin/TNF⁃αratio decreased significantly.This ratio may be an effective biomarker for assessing pregnant women's high risk of insulin resistance and dyslipidemia,as well as GDM diagnostic and treatment monitoring targets.