孕中期血浆脂联素水平与妊娠糖尿病相关性研究

目的:探讨孕中期血浆脂联素水平与妊娠糖尿病(GDM)的相关性.方法:选取305名孕妇于孕24～28周做75 g口服葡萄糖耐量试验(OGTT),空腹血样的检测指标包括血浆脂联素、血糖、胰岛素、游离脂肪酸(FFA)及血脂水平,OGTT 1 h、2 h血样检测指标包括血糖、胰岛素水平.结果:GDM孕妇孕中期血浆脂联素浓度明显低于糖耐量正常组(P=0.014);多元Logistic回归分析显示:在排除了血浆脂联素和FFA影响因素外,母亲孕前体重指数(BMI)和GDM仍保留着明显的相关性(P=0.017);肥胖妇女孕中期的脂联素水平明显低于非肥胖组;在正常糖耐量组,血浆脂联素水平与空腹胰岛素浓度、甘油三酯浓度、OGTT 1 h血糖水平、BMI(孕中期和分娩时)呈显著负相关,而与高密度脂蛋白和胆固醇浓度呈显著正相关;在GDM组,血浆脂联素水平与低密度脂蛋白浓度和新生儿出生体重显著负相关.结论:孕中期低脂联素水平与GDM高风险相关.

The correlation between midpregnancy adiponectin level and gestational diabetes mellitus

Objective:To study the correlation between midpregnancy adiponectin level and gestational diabetes mellitus(GDM). Methods:75 g oral glucose tolerance tests were performed in 305 pregnant women at 24 to 28 weeks of gestation. Fasting maternal blood samples were drawn to determine plasma concentrations of adiponectin,glucose,insulin,free fatty acid,and blood lipids. Blood samples at 1 and 2 h after an oral glucose load were obtained to measure plasma glucose and insulin concentrations. Results:Plasma adiponectin concentrations were significantly lower in women who had GDM than in those who had normal glucose tolerace(NGT)(P = 0.014). The multiple logistic regression model showed that the association between BMI before pregnancy and GDM remained significance(P = 0.017) after adjusting for plasma adiponectin and FFA concentrations. The obese women had significantly lower midpregnancy adiponectin concentrations than non-obese women. In the NGT group,maternal adiponectin concentrations were significantly negatively correlated with plasma fasting insulin,1-h glucose,triacylglycerol and maternal BMI(at blood collection and at delivery),and positively correlated with high-density lipoprotein cholesterol and total cholesterol concentrations.In the GDM group,maternal adiponectin level was negatively correlated with neonatal birth weight and low-density lipoprotein cholesterol concentrations. Conclusion:Midpregnancy lower adiponectin level might be associated with a higher risk of GDM.