妊娠期糖尿病患者分娩前后血清脂联素和胰岛素样生长因子-1的变化

摘要

目的 探讨妊娠期糖尿病患者分娩前后血清脂联素、胰岛素样生长因子-1的变化.方法 入选76例育龄妇女,其中31例为正常糖耐量非妊娠女性(G0),34例为正常糖耐量妊娠女性(G1),18例为妊娠期糖尿病患者(G2).在妊娠24周和分娩后6周检测空腹血糖、空腹胰岛素、血清脂联素和胰岛素样生长因子-1.采用稳态模式评估胰岛素抵抗和胰岛β细胞功能.结果 分娩前G0组血清脂联素水平高于G1组和G2组(P<0.05),但脂联素水平在G1组及G2组间比较差异无统计学意义(P>0.05).分娩后G1组血清胰岛素样生长因子-1水平较分娩前明显降低,而血清脂联素水平则明显升高(P<0.01).G2组分娩后脂联素水平低于G1组(P<1.05).结论 妊娠妇女血清脂联素水平下降,尤其是妊娠期糖尿病患者下降更明显.而分娩后血清脂联素有所恢复,低脂联素与胰岛素抵抗密切相关.%Objective To investigate the change of adiponectin and IGF-1 in gestational diadetes mellitns.Methods 76 women in reproductive age were enrolled,including 31 NGT( normal glucose tolerance) women without pregnancy( G0 ) ,34 NGT pregnant (G1 ) and 18 gestational diadetes mellitus (G2 ).Adiponectin as well as FBG, FINS were measured for all the objectives.IGF-I and adiponectin were followed up in all the pregnants.HOMA-IR and HOMA-β were calculated to assess insulin resisitance and βcell function.Results The level of serum adiponectin in Go was higher than that in G1 group and G2 group before delivery.The difference in adiponectin level between G1 and G2 was not significant.The level of IGF-1 decreased after delivery in G1 ,while the level of adiponectin increased(P ＜0.01 ).The level of adiponectin after delivery in G2 was lower than that in G1 ( P ＜ 0.05 ).Conclusion Adiponectin in pregunnt decreased,especially in gestational diadetes mellitus,and recovered partly in postpartum.The low level of adiponectin was correlated closely with insulin resistance.