孕期脂质过氧化作用与妊娠期糖尿病的相关性探讨

目的:研究妊娠期糖尿病(GDM)患者不同孕期体内脂质过氧化作用的变化,探讨脂质过氧化与GDM的相关性。方法:选择口服葡萄糖耐量试验诊断为GDM、经饮食治疗后血糖控制良好且足月分娩的31例单胎妊娠孕妇为研究对象,另选同期35名正常孕妇为正常对照组,分别采集妊娠中期、妊娠晚期和足月临产前的新鲜中段尿液,应用抗原标记酶联免疫法测定8-异前列腺素F2α(8-iso-PG2α)的水平,分析临床指标和妊娠结局与8-iso-PGF2α水平的相关性。结果:正常对照组妊娠中、晚期及足月临产前的尿8-iso-PGF2α水平比较差异无统计学意义(P>0.05);妊娠中期GDM组和正常对照组尿8-iso-PGF2α水平比较差异亦无统计学意义(P>0.05)。GDM组妊娠晚期和足月临产前尿8-iso-PGF2α水平比较差异无统计学意义,但较妊娠中期显著升高,同时也高于正常妊娠组(P<0.05)。GDM组足月临产前血细胞比容和血尿酸水平明显高于正常妊娠组并与足月临产前尿8-iso-PGF2α水平呈正相关(P<0.05),部分凝血活酶时间和凝血酶原时间明显低于正常妊娠组并与足月临产前尿8-iso-PGF2α水平呈负相关(P<0.05)。结论:妊娠过程中正常孕妇脂质过氧化作用保持稳定。GDM孕妇妊娠晚期脂质过氧化作用明显增强,饮食控制血糖水平正常者,异常增强的脂质过氧化作用仍未能恢复到正常水平。

Correlations between lipid peroxidation and gestational diabetes mellitus

Objective：To investigate the changes of peroxidation（LPO） level in pregnant women with gestational diabetes mellitus（GDM） at different gestational stages,and to analyze the role of LPO in the pathogenesis of GDM and their relationship.Methods： With healthy pregnant women as controls,pregnant women diagnosed by oral glucose tolerance tests（OGTT）as GDM were recruited as GDM group whose capillary whole blood glucose were appropriately kept by diet control and all experienced mature singleton pregnancy.Fresh urine samples were collected in three gestational stages respectively： second trimester,late pregnancy and term pregnancyand 8-iso-prostaglandinF2α（8-iso-PGF2α） levels was detected via Enzyme-linked immunosorbent assay（ELISA）.Moreover,the relative clinical indexes and pregnancy outcomes between normal and high-risk pregnancy were also compared with 8-iso-PGF2α.Results： No significant difference was found in the urine 8-iso-PGF2α levels in control group at any stage of pregnancy（P〉0.05）.There was no significant difference in the urine 8-iso-PGF2α level between GDM group and control group at the second trimester（P〉0.05）.In GDM group,the urine 8-iso-PGF2α levels in the late pregnancy and term pregnancy had no significant difference,but were higher than those in the second trimester and much higher than those of control group（P〈0.05）.Moreover,the hematocrit（HCT） and serum uric acid（UA） levels of GDM group were higher than those of control group and were positively correlated with the urine 8-iso-PGF2α level at term pregnancy（P〈0.05）.Activated partial thrombplastin time（APTT） and prothrombin time（PT） of GDM group were lower than those of control group and negatively correlated with the urine 8-iso-PGF2α level at term pregnancy（P〈0.05）.Conclusions： The LPO level in normal pregnant women kept stable during pregnancy,which may be necessary for maintaining normal pregnancy.For the pregnant women with GDM,abnormal increased LPO in the late pregnancy and term pregnancy may be an important risk factor withhyperglycemia,platelet activation and inflammation,Improving glucose metabolism and keeping appropriate blood glucose level could prevent LPO from further increasing,but could not reverse the increase of LPO.