血清铁蛋白及游离脂肪酸与妊娠期糖尿病胰岛素抵抗的相关性研究

目的：探讨血清铁蛋白（SF）及游离脂肪酸（FFA）与妊娠期糖尿病（GDM）患者胰岛素抵抗（IR）的关系，为早期干预GDM的发生发展提供依据。方法：2011年1月至2013年10月，以同期GDM组（71例）、正常孕妇组（50例）及正常非孕组（50例）为研究对象。同时检测空腹血清SF（电化学发光免疫法）、FFA（酶联法）、血糖（FBG）及胰岛素（Fins）水平[FBG，Fins，计算胰岛素抵抗指数（HOMA—IR）值1，并进行统计学分析。结果：正常非孕组、正常孕妇组及GDM组，三组血清sF水平（119．57±22．04，197．81±46．32，388．79±91．67）依次升高，且相差显著（F=57．543，P〈0．01），GDM组显著高于正常孕妇组（t=9．826，P〈0．01）；三组血清FFA水平（0．43±0．18，0．67±0．14，1．03±0．21）依次升高，且相差显著（F=37．619，P〈0．01），GDM组显著高于正常孕妇组（t=6．004，P〈0．01）；三组HOMA—IR值（1．83±0．45，2．92±0．87，3．94±1．02）依次升高，且相差显著（F=45．071，P〈0．01），GDM组显著高于正常孕妇组（t=11．183，P〈0．01）。GDM患者空腹血清SF、FFA水平分别与HoMA—IR值呈显著正相关（r=O．832、0．759，P〈0．01），空腹血清FFA水平与sF水平也呈显著正相关（r=0．893，P〈0．01），其相关性良好。结论：妊娠期糖尿病患者体内存在着高铁蛋白、游离脂肪酸血症及胰岛素抵抗状态，血清铁蛋白和游离脂肪酸水平与胰岛素抵抗相关，此为早期干预妊娠期糖尿病的发生发展提供了理论依据。

The correlation study between serum ferritin and free fatty acid and gestational diabetes insulin resistance

Objective ： Explore serum ferritin（SF） and free fatty acid（FFA） patients with gestational diabetes mellitus（GDM） the relationship between insulin resistance（IR）, provide the basis for early intervention of GDM development. Methods ： Between January 2011 to October 2013, with the same period the GDM group （71 cases） and normal pregnant woman group （50 cases） and normal non pregnant group （50 cases） as the research object. Fasting serum SF and FFA level detection by electrochemiluminescence immunoassay and enzyme-linked method respectively, while detecting FBG and the level of Fins, HOMA-IR was calculated, and statistical analysis.Results ： Normal non pregnant group and the normal pregnant women and GDM group,three groups of serum SF levels （119.57 ± 22.04, 197.81 ± 46.32, 388.79± 91.67）, in turn, increases, and differ significantly （F=57.543, P 〈 0.01）, the GDM group is significantly higher than normal pregnant women （t=9.826, P 〈 0.01）. Three groups of serum FFA levels （0.43± 0.18, 0.67 ± 0.14, 1.03 ＋ 0.21）, in turn, increases, and differ significantly （F=37.619, P 〈 0.01）, the GDM group is significantly higher than normal pregnant women （t=6.004, P 〈 0.01）.Three groups of HOMA-IR values （1.83 ± 0.45, 2.92 ± 0.87, 3.94 ±1.02）, in turn, increases, and differ significantly （F=45.071, P 〈 0.01）, the GDM group is significantly higher than normal pregnant women （t= 11. 183, P 〈 0.01）. GDM patients fasting serum SF, FFA levels respectively was inersely associated with HOMA-IR value has significant positive correlation （r=0.832, 0.759, P 〈 0.01）, fasting serum FFA levels and SF levels also has significant positive correlation （r=0.893, P〈0.01）, the correlation is good. Conclusions ： GDM patients has high SF and FFA concentration and IR state, SF and FFA levels associated with IR, this for early intervention of GDM development provides a theoretical basis.