GDM患者血同型半胱氨酸水平及其与血脂相关性研究

目的:研究妊娠期糖尿病(gestational diabetes mellitus,GDM)妇女血浆同型半胱氨酸(homocysteine,HCY)水平及其与血脂的相关性。方法:选择2011年12月～2012年10月在该院检查并分娩的GDM患者40例(GDM组),并以同期40例正常妊娠孕妇(正常组)为对照,详细记录两组分娩前血HCY、血脂【血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)】、空腹血糖、肌酐等数据。比较两组血HCY水平,并分析其与相关生化指标的相关性。结果:与正常组相比,GDM组血浆HCY水平及TG、LDL-C、FPG水平均显著增高(P<0.05);两组间血TC、HDL-C、肌酐比较,差异无统计学意义(P>0.05)。Spearman分析显示,血浆HCY水平与LDL-C显著正相关(P<0.05)。结论:GDM患者存在血HCY代谢异常,提示监测HCY水平对GDM患者病情的观察有一定指导意义;通过改善血脂水平,有助于降低血浆HCY浓度,减少血管病变性疾病的发生。

Relationship between blood homocysteine level and blood lipids of the patients with gestational diabetes mellitus

Objective:To study the blood homocysteine(HCY) level of the patients with gestational diabetes mellitus(GDM) and the correlation between HYC and blood lipids.Methods:40 GDM patients who received prenatal examination and deliveried in the hospital from December 2011 to October 2012 were selected into GDM group,and 40 normal pregnant women were selected into control group at the same time.The level of blood lipids,HCY,fasting plasma glucose(FPG),cretinine and so on in the two groups were recorded in detail.Detected blood lipids included serum total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C) and low density lipoprotein-cholesterol(LDL-C).The level of blood HCY in the two groups was compared and the correlations between HCY and related indexes(including blood lipids,FPG and the cretinine) were analyzed.Results:The level of blood HCY in GDM group was significantly higher than that of control group(P<0.05).There was no significant difference in TC,HDL-C and cretinine between the two groups(P>0.05).Compared with control group,the levels of TG,LDL-C,FPG in GDM group were increased significantly(P<0.05).Spearman analysis indicated that there was a positive correlation between blood HCY and serum LDL-C level(P<0.05).Conclusion:Patients with GDM have blood HCY metabolism disturbance,which indicates that monitoring the level of blood HCY is good for observing the state of illness of patients with GDM,and intervening the level of serum LDL-C may reduce the level of HCY and relieve the injuries of vessels.