妊娠期糖尿病孕妇血清脂联素水平变化与胰岛素抵抗关系的研究

目的:探讨妊娠期糖尿病孕妇血清脂联素水平变化与胰岛素抵抗的关系。方法:采用ELISA法测定30例妊娠期糖尿病孕妇(GDM组)、21例正常妊娠孕妇(NGT组)空腹血清脂联素水平,同时测定两组孕妇空腹血糖、胰岛素、C肽水平,计算胰岛素抵抗指数,以评价胰岛素抵抗程度。结果:(1)GDM组血清脂联素水平(1.65±0.69)显著低于NGT组(2.36±1.14)(P<0.01);GDM组胰岛素抵抗指数(3.58±1.01)显著高于NGT组(2.32±1.27)(P<0.01);(2)血清脂联素与胰岛素抵抗指数、孕前体重指数、孕前腰围、胰岛素呈显著负相关(P<0.05或P<0.01);(3)多元回归分析提示胰岛素抵抗指数、孕前体重指数是影响血清脂联素水平最显著的因素。结论:GDM组孕妇空腹血清脂联素水平明显降低,且与胰岛素抵抗指数呈显著负相关,提示脂联素对妊娠期糖尿病孕妇胰岛素抵抗具有保护作用。

Maternal serum adiponectin concentration and correlation with insulin resistance in gestational diabetes mellitus

Objective To investigate serum concentration of adiponectin and its correlation with insulin resistance in gestational diabetes mellitus.Methods ELISA was used to measure the fasting serum adiponectin levels of 30 patients with gestational diabetes mellitus and 21 normal pregnant women.Fasting plasma glucose,insulin,C-peptide were also measured at the same time.Insulin resistance index was caculated.Results(1)Decreased serum adiponectin was found in the patients with gestational diabetes mellitus compared with the normal pregnant women(P<0.01),insulin resistance index in the gestational diabetes mellitus patients was significantly higher than that in the normal pregnant women group(P<0.01).(2)Serum adiponectin was negatively correlated with insulin resistance index and other corresponding parameters.(3)The multivariate regression analysis was revealed that serum adiponectin was correlated significantly with insulin resistance index and BMI before pregnant.Conclusion Fasting plasma adiponectin levels in pregnant women with gestational diabetes mellitus is significantly lower than in normal pregnant women.A negative relationship between adiponectin and insulin resistance index is found in gestational diabetes mellitus,suggesting decreased adiponectin may contribute to insulin resistance in pregnant women with gestational diabetes.