妊娠糖尿病患者肿瘤坏死因子α的动态变化与胰岛素抵抗的关系

目的 探讨妊娠糖尿病(GDM)患者肿瘤坏死因子α(TNF-α)的动态变化与胰岛素抵抗(IR)的关系.方法 选择GDM患者32例(GDM组)、正常孕妇31例(NGT组)为研究对象,分别测定孕25~28周、孕29~32周、孕37~38周、产后6~8周空腹血TNF-α、胰岛素、血糖水平,采用放射免疫法测定TNF-α和胰岛素,葡萄糖氧化酶法测定空腹血糖.以稳态模式评估法的胰岛素抵抗指数(HOMA-IR)评价IR.结果 ① GDM组、NGT组血清TNF-α水平均随孕期的增加而升高,且均显著高于产后;② GDM患者妊娠各时期TNF-α水平均显著高于NGT (t值分别为7.81、7.05、7.15,P<0.01);③血清TNF-α水平与HOMA-IR显著正相关(r=0.571,P<0.05).结论 GDM患者血清中TNF-α水平随孕期的增加而升高,且显著高于产后,TNF-α的动态变化与IR相关.

Alteration of serum tumor necrosis factor-alpha level in gestational diabetes mellitus and correlation with insulin resistance

Objective To explore the dynamic of tumor necrosis factor-alpha(TNF-α)and its correlation with insulin resistance(IR)during different stages of gestational diabetes mellitus(GDM).Methods Thirty-two subjects with GDM and 31 cases of normal pregnant women nonnal glucose tolerance,NGT were enrolled in the study,serum TNF-α and insulin were determined by radioimmunoassay.The plasma glucose was measured by using glucose oxidase.Tests repeated for each group according different stages of prenatal 25～28 weeks,29～32 weeks,37～38 weeks and postpartum 6～8 weeks.IR was assessed by Serum TNF-α levels in GDM of above-mentioned four stages respectively were(7.05±0.67)ng/L,(7.11±0.75)ng/L,(7.36±0.79)ng/L,(5.46±0.37)ng/L respectively.All significantly increased than those in the HOMA-IR in GDM(r=0.571,P<0.05).Conclusions Serum TNF-α levels in GDM rose with gestational age,but significantly decreased at postpartum.The dynamic changes of serum TNF-α contribute to occurrence of insulin resistance.