血清脂肪因子omentin-1、chemerin的水平与妊娠期糖尿病的相关性

目的：探讨妊娠期糖尿病（GDM）患者血清脂肪因子omentin-1、chemerin水平变化及与GDM糖脂代谢、炎症指标等的相关性。方法 ELISA法定量85例GDM及匹配设置的85例糖耐量正常孕妇（NGT）血清omentin-1及chemerin水平，同时检测两组糖脂生化指标、炎症指标、空腹胰岛素（FINS）水平，计算胰岛素抵抗指数（HOMA-IR）。以单因素相关分析、多元逐步回归分析处理。结果（1）GDM组孕前BMI、hs-CRP、血脂、血糖、FINS、HOMA-IR、血清chemerin均明显高于NGT组，血清omentin-1明显低于NGT组（P<0.05）；（2）血清omentin-1：肥胖GDM<非肥胖GDM≈肥胖NGT<非肥胖NGT（P<0.05）；血清chemerin：肥胖GDM>非肥胖GDM≈肥胖NGT>非肥胖NGT（P<0.05）；（3）析因分析，产前肥胖和/或HOMA-IR≥2时，血清omentin-1水平明显降低；产前肥胖血清chemerin明显升高，但与HOMA-IR≥2无关联；（4）相关性分析：血清omentin-1与HDL明显正相关，而与孕前BMI、产前BMI、FPG、FINS及HOMA-IR明显负相关；chemerin与TC、TG、hs-CRP及FPG明显正相关；omentin-1和chemerin之间无明显相关性（P=0.301）；（5）孕前BMI、TG、FPG、FINS是GDM血清omentin-1的独立影响因素；TG、LDL、hs-CRP是GDM血清chemerin的独立影响因素。结论血清omentin-1可以反映孕妇糖、脂代谢紊乱和胰岛素抵抗程度，血清Chemerin则提示患者的高脂血症和慢性炎症状态。两者与GDM关系密切，可能共同参与了GDM疾病的发生和发展。

Correlation of serum omentin-1 and chemerin with gestational diabetes mellitus

Objective To investigate the relationship of serum omentin-1 and chemerin with gestational diabetes mellitus (GDM). Methods Serum levels of omentin-1 chemerin, glycolipids biochemical index, inflammation index, fasting insulin (FINS), and insulin resistance indexes (HOMA-IR) were determined in 85 women with GDM and 85 pregnant women with normal glucose tolerance (NGT). Results BMI, FPG, hs-CRP, blood lipids, blood glucose, FINS, HOMA-IR and serum chemerin level were all significantly higher while serum omentin-1 significantly lower in GDM group than in NGT group (P<0.05). In both groups, serum omentin-1 level was significantly lower and serum chemerin was significantly higher in obese subjects than in the non-obese subjects (P<0.05). Obesity before delivery and/or HOMA-IR ≥2 was associated with a significantly decreased serum omentin-1 level; serum chemerin increased significantly in obese women before delivery but was not associated with HOMA-IR. Serum omentin-1 level was positively correlated with HDL but inversely with BMI (at pregnancy and before delivery), FPG, FINS and HOMA-IR;Chemerin was positively correlated with TC, TG, hs-CRP and FPG;serum omentin-1 and chemerin levels were not significant correlated (P=0.301). In women with GDM, BMI at pregnancy, TG, FPG, and FINS were all independent factors affecting serum omentin-1; TG, LDL, and hs-CRP were independent factors affecting serum chemerin. Conclusion An decreased serum omentin-1 can be indicative of glucose and lipid metabolism disorder and insulin resistance, and an increased serum chemerin level indicates hyperlipidemia and chronic inflammation in pregnant women. Both of the adipokines are closed associated with GDM and probably participate in the occurrence and development of GDM.