血糖控制满意的妊娠期糖尿病孕妇血清抵抗素与妊娠结局的关系

目的 探讨血糖控制满意的妊娠期糖尿病（GDM）孕妇血清抵抗素水平、胰岛素抵抗与妊娠结局的关系.方法 选取孕24～ 28周GDM孕妇98例,其中血糖控制满意的72例为血糖控制满意组,血糖控制不满意的26例为血糖控制不满意组.选取同期孕24～28周健康孕妇95例为健康对照组.分别于孕24～28周和孕37 ～ 40周测定三组孕妇空腹血清抵抗素、空腹血糖（FPG）和空腹胰岛素（FINS）.计算稳态模型胰岛素抵抗指数（HOMA-IR）.记录并观察三组孕妇的妊娠结局.结果 血糖控制满意组孕妇的早产、妊娠期高血压疾病、羊水过多、巨大儿、新生儿窒息、新生儿低血糖、剖宫产的发生率明显低于血糖控制不满意组,两组比较差异有统计学意义（P＜0.05）;血糖控制满意组孕妇妊娠期高血压疾病、巨大儿的发生率与健康对照组比较差异有统计学意义（P＜0.05）,而早产、羊水过多、新生儿窒息、新生儿低血糖、剖宫产的发生率与健康对照组比较差异无统计学意义（P＞0.05）.孕24 ～ 28周时,血糖控制满意组抵抗素、FINS、FPG、HOMA-IR明显低于血糖控制不满意组,但明显高于健康对照组,组间比较差异均有统计学意义（P＜0.05）.孕37 ～ 40周时,血糖控制满意组FINS、HOMA-IR仍明显低于健康对照组,组间比较差异均有统计学意义（P＜0.05）;但血糖控制满意组抵抗素、FPG与健康对照组差异无统计学意义（P＞0.05）.结论 随着血糖水平控制,GDM患者抵抗素水平下降,但高胰岛素抵抗仍持续存在.血糖控制满意并不能完全改善GDM患者的妊娠结局.

The relationships between the serum levels of resistin and pregnancy outcomes in gestational diabetes mellitus pregnant women with well-controlled glucose

Objective To investigate the relationships among the serum levels of resistin,insulin resistance and pregnancy outcomes in gestational diabetes mellitus （GDM） pregnant women with well-controlled glucose.Methods A total of 98 GDM pregnant women of 24-28 weeks were recruited.Seventy-two cases of GDM with well-controlled glucose were defined as glycemic satisfied group,26 cases with unsatisfied glucose were defined as glycemic unsatisfied group.Ninety-five healthy pregnant women of 24-28 weeks at the same period were defined as healthy control group.Serum resistin,fasting plasma glucose （FPG）,fasting insulin （FINS） of all pregnant women were measured at 24-28 weeks and 37-40weeks.The Home model insulin resistance index（HOMA-IR） was calculated.The pregnancy outcomes of the three groups were recorded and observed.Results Glycemic satisfied group had less incidence of premature birth,hypertension disorders complicating pregnancy,polyhydramnios,fetal macrosomia,meonatal asphyxia,meonatal hypoglycemia,cesarean section compared to glycemic unsatisfied group,and the differences were statistically significant （P＜ 0.05）.When compared to healthy control group,no significant differences were found in incidence of premature birth,polyhydramnios,meonatal asphyxia,meonatal hypoglycemia,cesarean section in glycemic satisfied group（P ＞ 0.05）,but there were significant differences in incidence of hypertension disorders complicating pregnancy and fetal macrosomia in glycemic satisfied group （P ＜0.05）.At 24-28 weeks,resistin,FINS,FPG,HOMA-IR in glycemic satisfied group were significantly lower than those in glycemic unsatisfied group （P ＜ 0.05）,but which were higher than those in healthy control group （P ＜ 0.05）.At 37-40 weeks,FINS,HOMA-IR in glycemic satisfied group were significantly lower than those in glycemic unsatisfied group （P ＜ 0.05）,but there were no significant differences in resistin,FPG among three groups （P ＞ 0.05）.Conclusions The serum levels of resistin of GDM p