妊娠期糖尿病中医体质辨证及血清糖脂RBP4水平的关系研究

Study on the Relationship between Traditional Chinese Medicine Constitution Differentiation and Serum Glycolipid RBP4 Level for Puerperae with Gestational Diabetes Mellitus

目的:探究妊娠期糖尿病(GDM)产妇中医体质辨证及血清糖脂视黄醇结合蛋白4(RBP4)水平的关系。方法:选取2019年6月-2021年6月期间于我院就诊的142例GDM患者作为研究对象,对所有患者进行中医体质辨证分型,根据体质分型结果将其分为偏颇体质组和平和体质组。比较两组基线资料、糖代谢指标[空腹血糖(FPG)、餐后两小时血糖(2hPG)、糖化血红蛋白(HbAlc)]、血清RBP4、脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平,分析GDM患者体质偏颇的影响因素及与糖脂代谢、血清RBP4的关系。结果:所有患者经中医体质辨证分型后,发现体质偏颇患者115例(80.99%),体质平和患者27例(19.01%);偏颇体质组和平和体质组年龄、确诊孕周、收缩压、舒张压等资料无显著差异(P>0.05),偏颇体质组体质指数(BMI)、腰臀比显著大于平和体质组(P<0.05);偏颇体质组FPG、2hPG、HbAlc、RBP4、TC、TG、LDL-C水平均显著高于平和体质组(P<0.05),两组HDL-C水平比较无显著差异(P>0.05);Logistic回归分析得出,GDM患者体质偏颇与BMI、FPG、2hPG、HbAlc、RBP4、TC、TG、LDL-C水平相关(P<0.05)。结论:中医体质辩证属偏颇体质的GDM患者糖脂代谢紊乱较平和体质患者更严重,临床需引起充分重视,并通过相关血清指标进行评估,及时对偏颇体质患者予以治疗。

Objective:To explore the relationship between TCM constitution differentiation and serum glycolipid retinol-binding protein 4(RBP4)level for puerperae with gestational diabetes mellitus(GDM).Methods:142 patients with GDM treated in the hospital between June 2,019 and June 2,021 were selected as the research subjects,and all the patients were classified by the TCM constitution differentiation,and they were divided into a biased constitution group and a peaceful constitution group according to the constitution classification results.Baseline data,glucose metabolism indicators[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],serum RBP4 and lipid metabolism indicators[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]were compared between the two groups.The influencing factors of biased constitution in patients with GDM and their relationship with glucolipid metabolism and serum RBP4 were analyzed.Results:Among patients after TCM constitution differentiation classification,there were 115 cases(80.99%)of biased constitution and 27 cases of(19.01%)of peaceful constitution.There were no significant differences in the data such as age,gestational age of confirmed diagnosis,systolic blood pressure and diastolic blood pressure between the biased constitution group and the peaceful constitution group(P>0.05),and the body mass index(BMI)and waist-to-hip ratio in the biased constitution group were significantly higher than those in the peaceful constitution group(P<0.05).The levels of FPG,2hPG,HbAlc,RBP4,TC,TG and LDL-C were significantly higher in biased constitution group compared with those in peaceful constitution group(P<0.05),and there was no significant difference in the level of HDL-C between the two groups(P>0.05).Logistic regression analysis showed that the biased constitution of patients with GDM was related to BMI,FPG,2hPG,HbAlc,RBP4,TC,TG and LDL-C(P<0.05).Conclusion:The disorder of glucolipid metabolism in patients with GDM complicated with biased constitution of TCM constitution differentiation is more serious than that in patients with peaceful constitution,which needs to be paid full attention to in clinical practice.It is necessary to treat patients with biased constitution in time by evaluating the related serum indicators.