食欲素A水平与妊娠期糖尿病糖脂代谢指标及新生儿体重的相关性研究

目的探讨妊娠期糖尿病(GDM)患者血清、脐血食欲素A(orexin-A,OXA)水平与糖脂代谢指标及新生儿体重的相关性。方法收集90例GDM孕妇(GDM组)和50例正常孕妇(对照组),检测并比较两组孕妇分娩前总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及血清、脐血OXA水平,记录分娩后新生儿体重(BW),并对OXA水平、糖脂代谢指标及BW进行相关性分析。结果GDM组TC、LDL、TG、FPG、HbA1c、FINS、HOMA-IR及BW水平均高于对照组(P<0.05),血清、脐血OXA水平均显著低于对照组(P<0.05)。相关性分析显示BW与TC、LDL、TG、FPG、HOMA-IR呈正相关(P<0.05),血清OXA与LDL、FINS、HOMA-IR呈负相关(P<0.05),血清、脐血OXA水平与TC、TG、FPG及BW呈负相关(P<0.05)。结论血清、脐血OXA水平与GDM的发生、糖脂代谢异常及胎儿生长发育可能具有相关性。

Correlation between orexin-A level with glucose and lipid metabolism and the birth weight of newborns in women with gestational diabetes mellitus

Objective To investigate the correlation between serum and umbilical cord blood orexin-A(OXA)level with glucose and lipid metabolism and the birth weight of newborns in women with gestational diabetes mellitus(GDM).Methods Ninety pregnant women with GDM were collected as GDM group,and 50 normal pregnant women were collected as control group.The levels of total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),triglyceride(TG),fasting blood glucose(FPG),hemoglobin A1c(HbA1c),fasting insulin(FINS),insulin resistance index(HOMA-IR)and serum OXA were measured in pregnant women before delivery.And the birth weight(BW)of newborns and the umbilical cord blood OXA level were determined after delivery.The correlation between OXA level with glucose and lipid metabolism and BW were analyzed.Results TC,LDL,TG,FPG,HbA1c,FINS,HOMA-IR and BW in GDM group were higher than those in the control group(P<0.05),and the levels of serum and umbilical cord blood OXA were significantly lower than those in the control group(P<0.05);The correlation analysis showed that BW was positively correlated with TC,LDL,TG,FPG and HOMA-IR(P<0.05),serum OXA was negatively correlated with LDL,FPG,FINS and HOMA-IR(P<0.05),serum and umbilical cord blood OXA levels were negatively correlated with TC,TG,FPG and BW(P<0.05).Conclusion Serum and umbilical cord blood OXA levels are correlated with abnormal glucose and lipid metabolism,insulin resistance and fetal growth and development in GDM pregnant women.