超重孕妇肥胖抑制素、炎症因子水平及相关性研究

目的 探讨妊娠超重孕妇肥胖抑制素(obestatin)水平及其与胰岛素抵抗(insulin resistance,IR)、炎症因子的关系。方法 收集2016年12月～2018年3月上海市宝山区大场医院产科行常规产前检查的孕妇超重组69例、肥胖组36例,及同期健康孕妇66例,诊断标准参照《中国成人超重和肥胖症预防控制指南》。以生化免疫分析法检测胰岛素、肥胖抑制素、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)、C-反应蛋白(CRP)等相关实验指标。结果 超重组及肥胖组与对照组肥胖抑制素水平为304±58,275±57 vs 317±80 ng/L,差异具有统计学意义(F=4.235,P<0.05); 肥胖组与对照组CPR,TNF-α和IL-6水平为29.4±10.3 mg/L,56.8±9.0 pg/ml,36±8.1pg/ml vs 10.5±5.2 mg/L,40.3±10 pg/ml,28±8.4pg/ml,差异有统计学意义(F=3.10,3.24,3.31,均P<0.05); 超重孕妇肥胖抑制素水平与BMI,空腹血糖、胰岛素和HOMA-IR呈明显负相关(r=-0.41,-0.38,-0.35,-0.40,均P<0.01)。血清肥胖抑制素水平与CPR,TNF-α,IL-6水平呈负相关(r=-0.34,-0.36,-0.33,均P<0.05)。多元逐步回归分析,BMI和HOMA-IR是妊娠肥胖血清Obestatin水平的独立危险因素,差异有统计学意义(F=2.273,P=0.035)。结论 妊娠超重孕妇肥胖抑制素水平减低,炎症因子水平升高,其改变与胰岛素抵抗相关联。

Study on the Correlation between Obestatin and Inflammatory Factors in Prepregnancy Overweight Women

Objective To investigate the altered serum obestatin level and its correlation with inflammatory factors/insulin resistanc andin prepregnancy overweight and obesity women.Methods 69cases of prepregnancy overweight and 36 cases of obesity women(the gestational age of 37～40 weeks)diagnosed as prepregnancy overweight and obesity women inDachang Hospital of Baoshan District from December 2016 to March 2018 were chosed as the study group and other 66 cases of normal pregnant women were chosed asthe control group and the related indicators in the blood were examined.Results Obestatin levels of prepregnancy overweight,obesity women and control groups were 304±58,275±57 vs 317±80 ng/L(F=4.235,P<0.05),respectively.CPR,TNF-α and IL-6 were 29.4±10.3 mg/L,56.8±9.0pg/ml,36±8.1 pg/ml vs 10.5±5.2 mg/L,40.3±10 pg/ml,28±8.4 pg/ml,withstatistically significant differences(F=3.10,3.24,3.31,P=0.041,0.032,0.023),respectively.Obestatin levels of prepregnancy overweight and obesity women groups were negatively interrelated with BMI,glucose,insulin and HOMA-IR(r=-0.41,-0.38,-0.35,-0.40,P<0.01),and the same as CPR,TNF-α and IL-6(r=-0.34,-0.36,-0.33,P<0.05).The multiple stepwise regression analysis indicated that:BMI and HOMA-IR was an independent risk factor of the obestatin level in serum from the pregnancy overweight and obesity group(F=2.273,P=0.035).Conclusion Obestatin level significantly decreased and inflammatory factors increased in prepregnancyoverweight women and it was significantly correlated with IR.