妊娠并发糖代谢异常孕妇血清载脂蛋白变化

目的 :探讨妊娠糖代谢异常者血清载脂蛋白变化及有效血糖控制对血清载脂蛋白的影响 ,观察糖代谢异常并发妊高征 (PIH)时载脂蛋白的变化。方法 :测定 2 1例妊娠期糖耐量减低 (gestationalimpairedglucosetolerance ,GIGT)、2 6例妊娠期糖尿病 (gestationaldiabetesmellitus ,GDM)及 2 4例正常孕妇血清APOA1,APOB ,LP(a) ,并计算APOB APOA1(B A1) ,观察这些指标与糖代谢异常及并发妊高征之间的关系。结果 :(1)GDM及GIGT孕妇的APOB、LP(a)较正常孕妇有增高趋势 ,但无统计学差异 (P >0 0 5 )。在糖代谢异常孕妇中 ,血糖控制满意者APOB及B A1显著低于控制不满意者 (P <0 0 1) ,饮食 +胰岛素控制者APOB、B A1、LP(a)均明显低于单纯饮食控制者 (P <0 0 5 )。随孕周增长糖代谢异常孕妇APOA1有下降趋势 ,APOB有上升趋势 ,产后APOA1较血糖控制前明显降低 (P <0 0 1) ,B A1较控制前明显升高 (P <0 0 1) ;(2 )并发妊高征者与血压正常者各项载脂蛋白差异无显著性。结论 :妊娠糖耐量异常可伴血清载脂蛋白变化 ,有效控制血糖 ,有调节血脂作用

Changes of serum of apolipoproteins in patients with GDM and GIGT

Objective:To explore the changes of apolipoproteins in pregnant women with glucose intolerance and the effect of blood glucose control and whether apolipoproteins would change particularly when the women above compicated vascular disease pregnancy induced hypertension (PIH).Methods:21 cases of GIGT,26 cases of GDM and 24cases of control were studied.The concentration of APOA1,APOB and LP(a) in serum were measured,and APOB/APOA1(B/A1) was calculated.The changes of these indices in pregnant women with glucose intolerance were observed. Results: (1) APOB,LP(a) were higher in pregnant women with glucose intolerance than normal ones(P>0 05).In the glucose intolerant subjects ,the women with effective glucose control had lower APOB and B/A1 than those without satisfactory control(P<0.01);The women with diet and insulin treatment had lower APOB,B/A1,LP(a) than those with only diet control(P<0.05).Following pregnancy progress,APOA1 tended to descend and APOB tended to ascend(P>0.05).APOA1 descended and B/A1 ascended singnificantly postpartum than those of before control (P<0 01).(2)There was no difference in apolipoproteins between women with PIH and those without it. Conclusions:GDM and GIGT may have changes of aploipoproteins.Effective control of blood glucose may also regulate apolipoproteins.