血浆护骨素及有关因子水平在两组妊娠妇女间的比较

 摘要：目的 研究妊娠期糖尿病（GDM）和正常糖耐量(NGT)妊娠妇女在孕中晚期血浆护骨素及有关因子水平的比较。方法 收集NGT和GDM妊娠妇女各65例，于孕24-28周取静脉血5mL，置EDTA抗凝管中，3000r/min离心5min后留血浆，-20℃低温保存。用酶联免疫吸附测定法（ELISA）测定血浆护骨素(OPG)水平，同时测定空腹血糖(FPG),空腹胰岛素（FINS），糖化血红蛋白（HbA1c），血脂水平，超敏C反应蛋白（hs-CRP），血细胞计数，计算胰岛细胞功能（HOMA-B）和胰岛素抵抗（HOMA-IR）的评估指数。结果 血浆OPG水平在NGT和GDM组中无明显差异，在NGT组中，OPG与FINS (r=0.335;P=0.012)、HOMA-IR (r=0.363;P=0.006)、血小板计数(r=0.333;P=0.009)和载脂蛋白B(r=-0.254;P=0.043)水平相关,在GDM组，未发现上述指标与OPG水平相关。结论 在糖耐量正常孕妇中OPG可能参与了妊娠期的胰岛素抵抗和炎症反应，而其在妊娠期糖尿病组中的作用不明显,可能原因是OPG为影响胰岛素抵抗和炎症反应的较弱因素，在妊娠期糖尿病时，影响力更强的因素掩盖了其作用。

Comparision of plasma osteoprotegerin in women with gestational diabetes mellitus and normal glucose tolerance

Objective To determine the plasma osteoprotegerin(OPG) levels in pregnant women with gestational diabetes mellitus(GDM) and normal glucose tolerance(NGT) during their mid-late pregnancy,and to investigate the relationship between OPG and its involved factors.Methods Sixty-five women with GDM and 65 women with NGT were enrolled.Blood samples of each participant were collected during the 24~28 weeks of gestation and stored at-20 ℃ until use.Plasma concentration of OPG was measured by enzyme linked immunosorbent assay(ELISA).The level of fasting plasma glucose(FPG),fasting insulin(FINS),glycated hemoglobin(HbA1c),lipid,high-sensitivity C-reactive protein(hs-CRP),blood cell count,and calculated the homeostasis model assessment of beta-cell function(HOMA-B) and insulin resistance(HOMA-IR) were also measured.Results The levels of plasma OPG in GDM and NGT groups were 2 619[1 968,3 917] and 3 225[2 146,4 226] ng/L.There was no significant different between the two groups.In the group of NGT,OPG levels were positively correlated with FINS(r=0.335,P<0.05),HOMA-IR(r=0.363,P<0.05),platelet count(r=0.333,P<0.05) and negatively related with apolipoprotein B(r=-0.254,P<0.05),but in GDM group,the relation between OPG and the biomarker mentioned above was not found.Conclusions OPG may be involved in insulin resistance and inflammation during the pregnancy in women with NGT.