妊娠期糖代谢异常孕妇血清瘦素水平及其与胰岛素和血糖关系的研究

目的　探讨妊娠期糖代谢异常孕妇血清瘦素水平及其与胰岛素和血糖的关系。方法　采用放射免疫法 ,测定 36例妊娠期糖代谢异常孕妇 (糖代谢异常组 )和 2 4例正常孕妇 (正常妊娠组 )的空腹及口服 50g葡萄糖后 3h的血清瘦素水平 ;采用电化学发光法测定两组孕妇的空腹血清胰岛素水平 ;采用低压液相色谱分析法测定两组孕妇的糖化血红蛋白 ;采用葡萄糖氧化酶法测定两组孕妇的口服 50g葡萄糖后 1h的血糖水平。结果　 (1 )糖代谢异常组孕妇血清瘦素水平为 (1 4 9± 4 3) μg/L ,正常妊娠组为 (1 0 0± 1 8) μg/L ,两组比较 ,差异有极显著性 (P <0 0 1 ) ;(2 )糖代谢异常组孕妇空腹血清胰岛素、糖化血红蛋白、服糖后 1h血糖水平分别为 (1 2 9± 4 3)mU/L、 (6 1± 1 1 ) %、(1 1 0±1 4)mmol/L ;正常妊娠组孕妇分别为 (8 6± 3 2 )mU/L、(4 5± 1 0 ) %、(7 8± 1 2 )mmol/L。糖代谢异常组孕妇血清瘦素水平与空腹血清胰岛素、糖化血红蛋白、服糖后 1h的血糖水平呈明显的正相关关系 ,相关系数 (r)分别为 0 835、0 758、0 561。结论　妊娠期糖代谢异常孕妇空腹血清瘦素水平升高 ,其瘦素水平的高低与空腹血清胰岛素及血糖水平相关

Maternal plasma leptin levels and their relationship to insulin and glucose in pregnant women with gestational diabetes mellitus and gestational impaired glucose tolerance

OBJECTIVE: To investigate the changes in leptin levels and the relationship between the substance and insulin and glucose in pregnant women with gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT). METHODS: Radio immunoassay was used to measure the leptin levels at fasting and 3 h after oral glucose load (50 g) in 36 patients with GDM and GIGT, and also in 24 normal pregnant women. In each pregnant women, fasting serum insulin levels and glycosylated haemoglobin values were measured by electrochemiluminescent immunoassays and pressure liquid chromatography (LPLC) respectively, glucose levels 1 h after the administration of glucose by glucose oxidase method. RESULTS: The serum leptin levels in pregnant women with GDM and GIGT and normal pregnant women were (14.9 +/- 4.3) micro g/L and (10.0 +/- 1.8) micro g/L, respectively, suggesting the serum leptin levels were significantly higher in pregnant women with GDM and GIGT than in normal controls. The levels of fasting serum insulin, glycosylated haemoglobin values and plasma glucose levels obtained 1h after oral administration of 50 g glucose were (12.9 +/- 4.3) mU/L, (6.1 +/- 1.1)%, (11.0 +/- 1.4) mmol/L, respectively, whereas the corresponding values in normal controls were (8.6 +/- 3.2) mU/L, (4.5 +/- 1.0)%, (7.8 +/- 1.2) mmol/L. A positive correlation was found between maternal serum leptin levels and fasting serum insulin levels in pregnant women with GDM and GIGT (r = 0.835, P < 0.01). A positive correlation was also found between maternal leptin concentrations and glycosylated haemoglobin values, as well as between leptin levels and plasma glucose levels obtained 1 h after the administration of 50g glucose in women with GDM and GIGT (r = 0.758, P < 0.01; r = 0.561, P < 0.01). CONCLUSIONS: Leptin levels are elevated in pregnant women with GDM and GIGT compared with healthy pregnant women, a positive and significant correlation was found between the maternal leptin levels and fasting insulin levels, as well as between the maternal leptin levels and plasma glucose levels obtained 1 h after the administration of 50 g glucose in women with GDM and GIGT.