支链氨基酸补充方案中Betatrophin与妊娠期糖尿病患者糖脂代谢的相关性分析

Analysis on the correlations between Betatrophin and glucose and lipid metabolism in patients with gestational diabetes mellitus in branched-chain amino acid supplementation regimen

目的 分析支链氨基酸补充方案中Betatrophin与妊娠期糖尿病(GDM)患者糖脂代谢的相关性,探讨其对血糖监测的价值。方法 选取2019年12月—2020年12月中国人民解放军联勤保障部队第九〇三医院妇产科收治的120例GDM患者,依据治疗方法分为支链氨基酸补充组(IG组)和胰岛素治疗组(CG组),每组60例。分析Betatrophin水平与空腹血糖(FPG)、糖化血红蛋白(HbA1c)、糖化血清蛋白(GSP)、空腹C肽(FCP)、三酰甘油(TG)、总胆固醇(TC)及稳态模型的胰岛素抵抗指数(HOMA-IR)的相关性。结果 IG组和CG组Betatrophin、FPG、TG、TC、FCP及HOMA-IR水平比较差异均有统计学意义(均P<0.05)。在IG组,Betatrophin与FPG、TG、TC、FCP及HOMA-IR均呈正相关(r=0.838,P<0.001;r=0.557,P<0.001;r=0.124,P=0.211;r=0.413,P<0.001;r=0.837,P<0.001);在CG组,Betatrophin与FPG、TG、TC、FCP及HOMA-IR均呈负相关(r=-0.517,P=0.006;r=-0.416,P<0.001;r=-0.315,P=0.014;r=-0.817,P=0.016;r=-0.568,P<0.001)。在IG组,Betatrophin与HbA1c无相关性(r=0.293,P=0.103),Betatrophin与GSP呈正相关(r=0.872,P<0.001);在CG组,Betatrophin与HbA1c无相关性(r=0.179,P=0.262),Betatrophin与GSP呈负相关(r=-0.678,P=0.023)。结论 对GDM孕妇实施不同的治疗方案,Betatrophin不同程度参与糖脂代谢,补充支链氨基酸能促进糖脂代谢调节作用的发挥,Betatrophin或能成为一种血糖监测指标。

Objective To analyze the correlations between Betatrophin and glucose and lipid metabolism in patients with gestational diabetes mellitus(GDM) in branched-chain amino acid supplementation regimen, explore the value of Betatrophin for blood glucose monitoring. Methods From December 2019 to December 2020, 120 patients with GDM treated in Department of Gynecology and Obstetrics, 903 Hospital of Chinese People’s Liberation Army Joint Logistic Support Force were selected and divided into branched-chain amino acid supplementation group(IG group) and insulin therapy group(CG group), 60 cases in each group. The correlations between Betatrophin level and fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1 c), glycosylated serum protein(GSP), fasting C-peptide(FCP), triglyceride(TG), total cholesterol(TC), and homeostasis model assessment of insulin resistance(HOMA-IR) were analyzed. Results There were statistically significant differences in the levels of Betatrophin, FPG, TG, TC, FCP, and HOMA-IR between IG group and CG group(P<0.05). In IG group, Betatrophin was positively correlated with FPG, TG, TC, FCP, and HOMA-IR,respectively(r=0.838, P<0.001;r=0.557, P<0.001;r=0.124, P=0.211;r=0.413, P<0.001;r=0.837, P<0.001). In CG group, Betatrophin was negatively correlated with FPG, TG, TC, FCP, and HOMA-IR,respectively(r=-0.517, P=0.006;r=-0.416, P<0.001;r=-0.315, P=0.014;r=-0.817, P=0.016;r=-0.568, P<0.001). In IG group, Betatrophin was not correlated with HbA1 c(r=0.293, P=0.103), Betatrophin was positively correlated with GSP(r=0.872, P<0.001). In CG group, Betatrophin was not correlated with HbA1 c(r=0.179, P=0.262), Betatrophin was negatively correlated with GSP(r=-0.678, P=0.023). Conclusion Betatrophin is involved in glucose and lipid metabolism of pregnant women with GDM in different treatment regimens. Branched-chain amino acid supplementation can promote regulation of glucose and lipid metabolism, and betatrophin may be used as a blood glucose monitoring index.