血清脂联素水平与妊娠糖尿病患者胰岛素抵抗相关性

目的:探讨妊娠期糖尿病患者血清脂联素和TNF-α水平与胰岛素抵抗关系。方法:检测40例GDM患者(GDM组)、30例正常葡萄糖耐量妊娠(NGT组)血清脂联素、TNF-α,分析两者与胰岛素抵抗指数的相关性。同时用稳态模型法计算胰岛素抵抗指数。结果:与NGT组比较,GDM组血清脂联素水平明显下降(P<0.01)、TNF-α明显升高(P<0.01),脂联素与胰岛素抵抗(IR)呈负相关(r=-0.612,P<0.01)、TNF-α与胰岛素抵抗呈正相关(r=0.332,P<0.01)。GDM组多元线性逐步回归分析结果显示,孕前BMI、脂联素和TNF-α是影响GDM患者IR的独立危险因素。结论:GDM患者血清低脂联素水平、高TNF-α水平与IR密切相关,是妊娠糖尿病发生、发展的重要影响因素。

Relationship between serum adiponectin level and insulin resistance in women with gestational diabetes melitus

Objective:To explore the relationship between serum adiponectin level, tumor necrosis factor-α(TNF-α) and insulin resistance (IR) in women with gestational diabetes melitus (GDM).Methods:Serum adiponectin and TNF-α were detected in 40 patients with GDM (GDM group) and 30 healthy women (NGT group). Correlative analysis was carried out between serum adiponectin, TNF-α level and IR. The insulin resistance index (HOMA-IR) was calculated.Results:Serum adiponectin level was significantly lower in GDM group than that in NGT group(P<0.01). Serum TNF-α level was significantly higher in GDM group than that in NGT group (P<0.01). There was negative correlation between serum adiponectin level and IR (γ=-0.612,P<0.01) and positive correlation between serum TNF-α level and IR (γ=0.332,P<0.01). Multiple linear stepwise regression analysis indicated that body mass index(BMI), adiponectin and TNF-α were independent factors affecting IR.Conclusion:Low serum level of adiponectin and high serum level of TNF-α are related to IR in women with GDM and which may play an important role in the development of women with GDM.