摘要
目的通过测定妊娠期糖尿病患者血清中瘦素、可溶性瘦素受体(soulbe leptin receptor,sLR)、脂联素、抵抗素的含量,探讨脂肪细胞因子与妊娠期糖尿病发病的相关性,初步探索瘦素对胎儿发育的影响。方法选取2014年1-12月在厦门大学附属成功医院连续产检并分娩的673例孕妇为研究对象,跟踪随访至孕晚期。根据孕24~28周糖耐量试验结果,采用随机抽样选取50例血糖控制良好的妊娠糖尿病患者纳入妊娠糖尿病组,根据一般资料进行匹配选取50例糖耐量试验结果阴性者纳入正常妊娠组。另根据一般资料进行匹配选取50例同期门诊未孕女性糖尿病患者为未孕糖尿病组。测定3组研究对象不同孕期血清瘦素、sLR、脂联素、抵抗素含量及生化指标,精确测量新生儿生长发育指标,分析瘦素与新生儿生长发育指标及sLR、脂联素、抵抗素的相关性。采用SPSS19.0软件进行结果分析。结果妊娠糖尿病组新生儿出生体重明显高于正常妊娠组(P<0.05)。与正常妊娠组比较,妊娠糖尿病组及未孕糖尿病组患者血清瘦素及抵抗素水平、空腹血糖(FPG)、空腹胰岛素(Fins)、胰岛素抵抗指数(HOMA-IR)明显升高(P<0.01),sLR、脂联素水平明显降低(P<0.01)。与未孕糖尿病组比较,妊娠糖尿病组患者血清瘦素及抵抗素水平、FPG、糖化血红蛋白(HbA_1c)明显升高(P<0.05),sLR及脂联素水平明显降低(P<0.05)。妊娠期糖尿病组患者血清瘦素含量与sLR、脂联素均呈负相关(r=-0.16,-1.13,P<0.01),与抵抗素呈正相关(r=0.269,P=0.019),与新生儿出生体重无显著相关性(P=0.216)。结论瘦素影响胎儿宫内生长发育,妊娠期糖尿病患者血清瘦素水平与sLR、抵抗素和脂联素之间存在一定关联,与胎儿体重无明显相关性。
Objective To detect the serum leptin,soulbe leptin receptor（ sLR）,adiponectin and resistin concentration in pregnant women with gestational diabetes mellitus（ GDM）. Methods Venous blood samples were taken in pregnant women with GDM（ GDM,n = 50） and normal pregnant women（ NGT,n = 50） between 24 and 28 gestational weeks for the measurements of serum leptin,sLR,adiponectin,resistin and biochemical indexes. And age-matched diabetes non-pregnant women（ DM,n = 50） were enrolled in this case-control study. Neonatal anthropometry were immediately measured after their delivery. The levels of leptin,sLR,adiponectin and resistin,and the indicators of growth and development were compared. The results were analyzed by using SPSS19.0 software. Results Neonatal weight in GDM group was higher than in the normal pregnant women group（ P 0. 05）. Leptin,resinstin content,FPG,Fins and HOMA-IR in GDM group and DM group were higher than that in the normal pregnant women group. sLR andadiponectin content were lower than that in the normal pregnant women group,the difference was statistically significant（ P〈0.01）. Leptin, resinstin content, FPG and HbA1c in GDM group were higher than that in the DM group. sLR and adiponectin content was lower than in the DM group, the difference was statistically significant（ P 0. 05）. Leptin content was negatively correlated with sLR, adiponectin（ r=-0. 16,-1. 13,P〈0.01）,and positively correlated with resistin（ r=-0.269,P = 0.019）,and had no significant difference with infant birth weight（ P = 0.216）. Conclusion Leptin affects fetal growth and development. There was high correlation between serum leptin,sLR,adiponectin and resistin.
作者
林戎
沈忱
兰天舒
黄昭穗
LIN Rong;SHEN Chen;LAN Tian-shu;HUANG Zhao-sui(Department of Endocrinology, Chenggong Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian, China;Department of Basic Medicine, Xiamen Medical College, Xiamen 361023, Fujian, China)
出处
《东南国防医药》
2018年第3期236-239,共4页
Military Medical Journal of Southeast China
基金
厦门市科技计划项目(3502z20144040)
