妊娠期糖尿病患者血清Betatrophin含量检测及其与机体糖脂代谢紊乱的关系

目的探讨妊娠期糖尿病(GDM)患者血清Betatrophin含量与机体糖脂代谢紊乱的关系。方法前瞻性选取2018年12月至2020年1月在庆阳市人民医院进行糖耐量筛查并确诊为GDM的孕妇117例作为GDM组,同期在本院进行糖耐量筛查的健康孕妇100例作为正常对照组。比较2组孕妇的血清Betatrophin含量、外周血糖代谢指标(空腹血糖、空腹胰岛素、胰岛β细胞分泌功能、胰岛素抵抗指数)、脂质代谢指标总胆固醇(TC)、载脂蛋白A1(Apo-A1)、载脂蛋白-B(Apo-B)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平差异。采用Pearson检验评估GDM孕妇血清Betatrophin与糖脂代谢紊乱程度的相关关系。结果GDM组孕妇血清中Betatrophin的含量为(309.47±38.66)pg/mL,高于正常对照组孕妇(217.66±25.73)pg/mL],差异有统计意义(P<0.05)。GDM组孕妇的空腹血糖、空腹胰岛素、胰岛素抵抗指数分别为(5.47±0.71)mmol/L、(12.37±1.95)pmol/mL、(2.88±0.35),高于正常对照组孕妇(4.38±0.56)mmol/L、(7.54±0.92)pmol/mL、(1.34±0.19)],胰岛β细胞分泌功能为(140.64±17.29),低于正常对照组孕妇(161.33±18.51),差异有统计意义(P<0.05)。GDM组孕妇的TC、Apo-B、LDL-C水平分别为(5.98±0.7)mmol/L、(1.76±0.21)g/L、(2.98±0.37)mmol/L,高于正常对照组孕妇(5.60±0.76)mmol/L、(1.54±0.18)g/L、(2.62±0.34)mmol/L],Apo-A1、HDL-C水平为(0.91±0.10)g/L、(1.70±0.19)mmol/L,低于正常对照组孕妇(1.12±0.14)g/L、(1.96±0.24)mmol/L],差异有统计意义(P<0.05)。相关性分析发现,GDM孕妇血清Betatrophin含量与糖代谢指标空腹血糖、空腹胰岛素、胰岛素抵抗指数呈正相关(r=0.827、0.716、0.704),与胰岛β细胞分泌功能呈负相关(r=-0.793);与脂质代谢指标TC、Apo-B、LDL-C水平呈正相关(r=0.665、0.684、0.833),与Apo-A1、HDL-C水平呈负相关(r=-0.711、-0.675,P<0.05)。结论GDM孕妇血清Betatrophin含量可客观反映机体糖脂代谢紊乱程度,是病情评估的简便指标之一。

Detection of serum Betatrophin in patients with gestational diabetes mellitus and its correlation with glucose and lipid metabolism disorder

Objective To investigate the correlation between serum Betatrophin level,glucose and lipid metabolism disorders in patients with gestational diabetes mellitus(GDM).Methods 117 cases of GDM patients diagnosed in Qingyang People's Hospital during December 2018 to January 2020 were chosen as GDM group,100 cases of healthy pregnant women underwent glucose tolerance screening in our hospital were treated as normal control group.Differences in serum Betatrophin content,glucose metabolism indexes(fasting blood glucose,fasting insulin,pancreatic β cell secretion function,insulin resistance index),lipid metabolism indexestotal cholesterol(TC),apolipoprotein A1(Apo-A1),apolipoprotein-B(Apo-B),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]in peripheral blood of two groups were compared.The correlation between serum Betatrophin and the degree of glucose and lipid metabolism disorders in pregnant women with GDM was evaluated using Pearson test.Results The content of Betatrophin in the serum of pregnant women in the GDM group was(309.47±38.66)pg/mL,which was higher than that in the normal control group(217.66±25.73)pg/mL],the difference was statistically significant(P<0.05).The fasting blood glucose,fasting insulin and insulin resistance index of pregnant women in the GDM group were(5.47±0.71)mmol/L,(12.37±1.95)pmol/mL,and(2.88±0.35),respectively,which were higher than those of the normal control group(4.38±0.56)mmol/L,(7.54±0.92)pmol/mL,(1.34±0.19)],pancreaticβ-cell secretion function was(140.64±17.29),which was lower than that of normal control pregnant women(161.33±18.51),the differences were statistically significant(P<0.05).The levels of TC,Apo-B and LDL-C of pregnant women in the GDM group were(5.98±0.7)mmol/L,(1.76±0.21)g/L,and(2.98±0.37)mmol/L,respectively,which were higher than those of the normal control group(5.60±0.76)mmol/L,(1.54±0.18)g/L,(2.62±0.34)mmol/L],Apo-A1 and HDL-C levels were(0.91±0.10)g/L,(1.70±0.19)mmol/L,which were lower than normal control group of pregnant women(1.12±0.14)g/L,(1.96±0.24)mmol/L],the differences were statistically significant(P<0.05).Correlation analysis found that serum Betatrophin content of GDM pregnant women was positively correlated with glucose metabolism indicators,fasting blood glucose,fasting insulin,and insulin resistance index(r=0.827,0.716,0.704),and negatively correlated with pancreaticβ-cell secretion function(r=-0.793);It is positively correlated with lipid metabolism indexes TC,Apo-B,LDL-C levels(r=0.665,0.684,0.833),and negatively correlated with Apo-A1,HDL-C levels(r=-0.711,-0.675,P<0.05).Conclusion Level of Betatrophin in GDM pregnant women can objectively reflect the degree of glucose and lipid metabolism disorder,it is one of the simple index for disease evaluation.