子痫前期患者血清脂联素表达水平与血脂代谢及胰岛素抵抗的相关性

目的:探讨脂联素、血脂代谢及胰岛素抵抗与子痫前期发病的关系。方法:选择2007年9月—2008年7月住院分娩的妊娠妇女120例及妊娠前健康体检妇女30例,其中60例子痫前期妊娠妇女按发病时妊娠周不同分为早发型组(29例,发病时妊娠周≤34周)和晚发型组(31例,发病时妊娠周>34周)。60例正常晚期妊娠妇女分为妊娠≤34周组和妊娠>34周组,各30例;采用酶联免疫吸附法(ELISA)检测各组血清脂联素与胰岛素水平;应用全自动生化分析仪测定血脂、血糖水平。检测临床相关指标,包括血压、妊娠前体质量等,并进行相关性分析。结果:①早发型子痫前期组血清脂联素低于同期对照组,晚发型子痫前期组血清脂联素低于同期对照组,差异均有统计学意义(P<0.05);且早发型组低于晚发型组,差异有统计学意义(P<0.05),校正红细胞压积(HCT)后,仍有统计学意义。②早发型、晚发型子痫前期组血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、载脂蛋白B(ApoB)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(IRI)均高于同期对照组,而高密度脂蛋白(HDL)、载脂蛋白A1(ApoA1)低于同期对照组(均P<0.05)。③早发型、晚发型子痫前期组血清脂联素与TG、收缩压(SP)、舒张压(DP)、平均动脉压(MAP)及IRI均呈负相关;与HDL呈正相关。结论:子痫前期妊娠妇女血清脂联素表达降低可能与子痫前期发病有关;血脂代谢异常及胰岛素抵抗与子痫前期患者脂联素表达降低有关,可能参与低脂联素促发子痫前期的病理生理机制。

The Levels of Adiponectin,Lipids and Insulin Resistance and Their Relationship in Women with Pre-eclampsia

Objective:The purpose of the study was to detect the serum levels of adiponectin,insulin resistance and lipid metabolism in pre-eclampsia(PE),and to discuss their roles in the pathogenesis of PE.Methods:The level of adiponectin in serum was detected by enzyme-linked immunosorbent assay,and lipid and lipoprotein were detected with biochemistry analyzer in a control group of thirty nonpregnant women,in sixty normal third-trimester pregnant women,and in sixty cases of women with PE.Results:①Women with early-onset had a lower serum adiponectin level than its control.group Women with late-onset had a lower serum adiponectin level than its control(P<0.05).Women with early-onset PE had a lower serum adiponectin level than late-onset PE group(P<0.05).The differences were still significant after correction for haematocrit.②In early-onset and late-onset PE group,the levels of total cholesterol(TC),triglyeride(TG),low density lipoprotein cholesterol(LDL),apolipoproteinB(ApoB) insulin and insulin resistance index(IRI) were higher than that of their controls,while high density lipoprotein cholesterol(HDL) and apolipoproteinA1(ApoA1) were lower than that of their controls(P<0.05).③In early-onset and late-onset PE groups,the serum adiponectin was negatively related to the serum TG,systolic pressure(SP),diastolic pressure(DP),mean arterial blood pressure(MAP) and IRI,while the serum apdionectin was positively related to the serum HDL.Conclusions:Decreased adiponectin expression in serum may be involved in the pathogenesis of PE.Dyslipidemia and insulin resistance may be associated with decreased adiponectin expression in patients with PE,and may be involved in the pathophysiology of hypoadiponectinemia led to development of PE.