妊娠期高血压疾病患者血清脂联素水平的变化与胰岛素抵抗的关系

目的:探讨不同程度妊娠期高血压疾病(HDCP)患者血清脂联素(APN)水平变化及其与胰岛素抵抗的关系。方法:以100例妊娠期高血压疾病孕妇为研究对象,其中轻度子痫前期69例,重度子痫前期31例;选取同期100例正常孕晚期孕妇为对照组。采用酶联免疫吸附法(ELISA法)检测孕妇血清脂联素水平,同时检测空腹血糖(FBG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(IRI)。结果:轻度、重度子痫前期患者血清脂联素水平分别为(9.29±3.30)μg/ml和(7.53±2.68)μg/ml,明显低于对照组(11.22±2.75)μg/ml,差异有统计学意义(P<0.01),轻度、重度子痫前期患者胰岛素抵抗指数明显高于对照组(P<0.01),脂联素水平与胰岛素抵抗指数呈显著负相关(r=-0.750,P<0.01)。结论:脂联素水平在妊娠期高血压疾病患者中明显降低,脂联素水平与胰岛素抵抗指数呈显著相关性,提示脂联素在妊娠期高血压疾病发病中可能起着一定的作用,其作用机制与增强胰岛素抵抗有关,可以作为HDCP发病及严重程度的一个预测指标。

Relationship between the change of serum adiponectin level and insulin resistance in patients with hypertensive disorder complicating pregnancy

Objective:To explore the relationship between the change of serum adiponectin level and insulin resistance in patients with hypertensive disorder complicating pregnancy(HDCP) of different degrees.Methods:One hundred patients with HDCP were selected as study objects,including 69 patients with mild preeclampsia and 31 patients with severe preeclampsia;100 normal pregnant women during the third trimester of pregnancy were selected at the same time as control group.Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum adiponectin level,fasting blood glucose(FBG) and fasting insulin(FINS) were measured at the same time,insulin resistance index was calculated.Results:The serum adiponectin levels in mild preeclampsia group and severe preeclampsia group were(9.29±3.30) μg/ml and(7.53±2.68) μg/ml,respectively,which were significantly lower than that in control group((11.22±2.75) μg/ml)(P<0.01).The insulin resistance indexes in mild preeclampsia group and severe preeclampsia group were significantly higher than that in control group(P<0.01).There was a significant negative correlation between serum adiponectin level and insulin resistance index(γ=-0.750,P<0.01).Conclusion:The serum adiponectin level decreases significantly in patients with HDCP,and it is correlated with insulin resistance index significantly,which indicates that adiponectin may play a certain role in the pathogenesis of HDCP,and the mechanism is related to the enhancement of insulin resistance,the serum adiponectin level can be used as a predictor of occurrence and degree of severity of HDCP.