Betatrophin影响妊娠期糖尿病母儿糖脂代谢的研究

目的探讨不同孕期妊娠期糖尿病(GDM)孕妇中,血浆和脐血Betatrophin水平对母儿糖脂代谢的影响。方法随访2016年9月至2019年1月于青岛市立医院产检并分娩的正常孕妇(正常组)和GDM孕妇(GDM组)各50例,收集孕妇的基本临床资料,分别于中、晚孕期检测母体血浆和脐血中糖脂代谢的相关指标,包括空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG),计算胰岛素抵抗指数(HOMA-IR);ELISA法检测血浆和脐血Betatrophin水平。结果中孕期GDM组母体血浆及脐血Betatrophin水平均显著高于正常组(t值分别为-2.53、-3.91,均P<0.05),晚孕期两组Betatrophin水平差异无统计学意义(P>0.05)。Pearson相关性分析显示,中孕期GDM孕妇血浆Betatrophin水平与FPG、HOMA-IR、TG均呈正相关(相关系数r分别为0.31、0.63、0.58,均P<0.05),晚孕期血浆Betatrophin水平与FPG、HOMA-IR均呈正相关(相关系数r分别为0.67、0.61,均P<0.05)。GDM组脐血Betatrophin水平与母体血浆Betatrophin水平及脐血FPG、HOMA-IR、TG均呈显著正相关(相关系数r分别为0.32、0.32、0.30、0.27,均P<0.05)。结论GDM孕妇的Betatrophin水平可能影响不同时期的母体糖脂代谢,且随着改善性治疗发生改变,同时对胎儿的糖脂代谢存在一定影响。

The effect of Betatrophin on maternal-fetal glucolipid metabolism in patients with gestational diabetes mellitus

Objective To explore the effects of Betatrophin level in plasma and umbilical blood on maternal-fetal glucolipid metabolic in pregnant women with gestational diabetes mellitus(GDM)during different gestational periods.Method From December 2016 to January 2019,we collected 50 cases of healthy pregnant women(normal group)and 50 cases of pregnant women with GDM(GDM group)who have prenatal examination and delivery in Qingdao Municipal Hospital.The basic clinical data of pregnant women were collected.The related indexes of glucolipid metabolism in maternal plasma and umbilical cord blood,including fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),were detected in middle and late pregnancy,respectively,and homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.In addition,umbilical blood was taken at delivery and ELISA was used to test Betatrophin level of the plasma and umbilical blood.Results In GDM group,the Betatrophin level in maternal plasma and umbilical blood during middle pregnancy were significantly higher than those in normal group(t=-2.53 and-3.91,respectively,both P<0.05),but no significant difference was found in Betatrophin level during late pregnancy between the two groups(P>0.05).Pearson correlation analysis showed that plasma Betatrophin level was positively correlated with FPG,HOMA-IR and TG during middle pregnancy in pregnant women with GDM(r=0.31,0.63 and 0.58,respectively,all P<0.05),and the plasma Betatrophin level was positively correlated with FPG and HOMA-IR during late pregnancy in GDM group(r=0.67 and 0.61,respectively,both P<0.01).In addition,the Betatrophin level in umbilical blood was positively correlated with the plasma Betatrophin level during late pregnancy,as well as FPG,HOMA-IR and TG in umbilical blood for pregnant women with GDM(r=0.32,0.32,0.30 and 0.27,respectively,all P<0.05).Conclusion The level of Betatrophin in pregnant women with GDM might affect maternal glucolipid metabolism at different periods,which change with the improvement therapy and also has a certain influence on fetal glucolipid metabolism.