血清脂肪细胞因子与妊娠期糖尿病关系的研究

探讨妊娠期糖尿病(gestational diabetes mellitus, GDM)孕妇血清脂肪细胞因子即脂连素、TNF α、瘦素与妊娠 期糖尿病发生发展的关系。方法：测定50例GDM孕妇和36例正常孕妇（NGT）血清脂连素、瘦素与TNF α浓度及相关参数浓度。采用放射免疫法 测定脂连素、瘦素及C肽浓度，ELISA法检测血清TNF α浓度，电化学发光法检测胰岛素浓度，采用低压液相色谱分析法和葡萄糖氧化酶法分别 检测糖化血红蛋白和血糖。结果: ① GDM孕妇血清TNF α［（4.6±1.5）pg/ml］水平明显高于NGT［（3.3±1.6）pg/ml］，且GDM组TNF α 与胰岛素、血糖、C肽、HbA1c浓度呈正相关关系；② GDM孕妇血清脂连素浓度［（10.3±2.4）μg/ml］明显低于NGT孕妇［（15.6±3.2） μg/ml］, GDM组脂连素浓度与胰岛素、血糖、C肽、HbA1c浓度呈负相关关系；③GDM孕妇血清瘦素水平［（15.3±3.8）ng/ml］ 明显高于NGT ［（ 10.3±2.1）ng/ml］，GDM组血清瘦素浓度与胰岛素、血糖、C肽、HbA1c浓度呈正相关关系。结论：血清脂肪细胞因子直接或间接地参与 妊娠期糖尿病发生发展，是代谢综合征的重要预测因子。

Relationship between pregnancy induced diabetes and adipocytokins

o explore the relationship between the serum adipocytokins of adiponectin, TNF α and leptinin and pregnancy induced diabetes. Methods:Radioimmunoassay was used to detect the serum adiponectin, leptin and c peptide ELISA was applied to detect TNF α levels in 50 women with pregnancy induced diabetes and 36 normal pregnant women, electrochemiluminescent immunoassays and pressure liquid chromatography(LPLC) were used to measure serum insulin and HbA1c respectively, and glucose oxidase method to measure the fasting glucose levels. Results: Compared with the normal pregnant women, adiponectin was significantly lowered ［(10.3±2.4)ug/ml vs（15.6±3.2）μg/ml］, TNF α was elevated ［(4.6±1.5)ng/ml vs（3.3±1.6）pg/ml］, and leptin significantly highered ［(15.3±3.8)ng/ml vs （ 10.3±2.1）ng/ml ］ in women with pregnancy induced diabetes; TNF α and leptin levels positively correlated with serum insulin levels, glucose levels, C peptide and HbA1c, whereas adiponectin negtively with the corresponding parameters. Conclusions: ⑴ Women with pregnancy induced diabetes have significantly lower adiponectin and higher TNF α and leptin in comparison to normal pregnant women;⑵ Elevated TNF α, leptin and decreased adiponectin may not simply reflect maternal insulin resistant state, but contribute to the impaired glucose metabolism during pregnancy and increase risk for the development of type 2 diabetes. Adipocytokins may forecast the risk of metabolism syndrome.