妊娠糖尿病患者孕晚期血清HbA1c、RBP4及脂联素水平与妊娠结局

Analysis of serum levels of HbA1c, RBP4, and adiponectin of women with gestational diabetes mellitus during the third trimester and their correlation to pregnancy outcomes

目的:探究妊娠糖尿病(GDM)患者孕晚期血清糖化血红蛋白(HbA1c)、视黄醇结合蛋白4(RBP4)及脂联素(ADP)水平与妊娠结局关系。方法:选择2014年4月—2015年9月本院收治的孕≥28周GDM患者96作为观察组,另选同期健康体检≥孕28周孕妇50例作为对照组,检测两组血清HbA1c、RBP4、ADP水平,并记录妊娠结局。结果:观察组血清HbA1c和RBP4水平高于对照组,ADP水平低于对照组(均P<0.05);GDM患者孕晚期血清HbA1c、RBP4、ADP水平均与产妇妊娠期间高血压、早产、生殖道感染、胎儿窘迫、巨大儿比例有关(P<0.05);logistic分析,血清HbA1c、RBP4及ADP水平为影响GDM患者孕晚期不良妊娠结局的危险因素。结论:GDM患者孕晚期血清HbA1c、RBP4水平升高,ADP水平降低,且均与妊娠结局有关,检测GDM患者血清HbA1c、RBP4、ADP对判断妊娠结局和评价改善状况有重要临床意义。

Objective:To investigate the correlation between levels of serum glycosylated hemoglobin(HbA1 c),retinol binding protein 4(RBP4),and adiponectin(ADP)of women with gestational diabetes mellitus(GDM)during the third trimester,and to explore the influence of the levels of HbA1 c,RBP4,and adiponectin on pregnancy outcomes.Methods:From April 2014 to September 2015,96 women with GDM who had over 28 gestational weeks were selected in observation group,and another 50 healthy pregnant women also over 28 gestational weeks were in control group.The levels of serum HbA1 c,RBP4 and ADP of all women were detected,and the pregnancy outcomes of all women were recorded.Results:The levels of serum HbA1 c and RBP4 of women in observation group were significant higher than those of women in control group(P<0.05),and the ADP level of women was significant lower than that of women in control group(P<0.05).The levels of serum HbA1 c,RBP4 and ADP of women in observation group were related to the rates of pregnancy hypertension,premature delivery,genital tract infection,fetal distress and macrosomia(P<0.05).Logistic analysis showed that levels of serum HbA1 c,RBP4 and ADP were risk factors of adverse pregnancy outcomes.Conclusion:In women with GDM during the third trimester,the levels of serum HbA1 c and RBP4 are increased and ADP level is decreased,which is related to the pregnancy outcomes.The detection of serum HbA1 c,RBP4 and ADP of women with GDM during the third trimester has great significance for judging and assessing pregnancy outcomes.