妊娠糖尿病患者脂联素和瘦素与胰岛素抵抗的相关性研究

摘要

Objective To study correlation between the insulin resistancce, adiponectin and leptin in patients with gestational diabetes mellitus. Methods A case-match study was carried out. Fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol(LDL-C), adiponectin(ADP) and leptin(LEP) were measured in 30 gestational diabetes mellitus (group A) and 30 pregnant women with normal glucose tolerance(group B), retrospectively. Insulin resistance(HOMA-IR) was calculated. The changes of the indicators were observed and their correlation were analyzed. Results Compared with group B, FBG, FINS, TG, TC, ADP, LDL-C were significantly increased(P<0.05). LEP was significantly reduced and HDL-C was no significantly changed in group A. Multiple regression analysis showed that there was negative correlation between LEP and IR and positively with ADP. Conclusion Lower ADP may be a risk factor for gestational diabetes mellitus with insulin resistance. And insulin resistance closely related to serum LEP. Actively improve the ADP and giving extrinsic anti-LEP drugs maybe provide a new avenue to the treatment of gestional diabetes mellitus.%目的探讨妊娠糖尿病患者脂联素和瘦素与胰岛素抵抗之间的关系。方法采用病例对照法，分别测定30例单纯妊娠糖尿病组及30名健康妊娠组的空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、总胆固醇（TC）、甘油三酯（TG），计算胰岛素抵抗指数（HOMA-IR），同时测定血清瘦素和脂联素，观察各指标的差异，分析其相互关系。结果与健康妊娠组比较，妊娠糖尿病组患者的FBG、FINS、TG、TC、瘦素、低密度脂蛋白胆固醇明显升高，存在更明显的胰岛素抵抗。脂联素有显著的降低，高密度脂蛋白胆固醇差异无统计学意义（P<0.05）。多元回归分析显示妊娠糖尿病患者胰岛素抵抗与瘦素呈正相关，与脂联素呈负相关。结论低水平脂联素是妊娠糖尿病胰岛素抵抗的危险因素，且胰岛素抵抗与血清瘦素水平密切相关，因此积极给予外源性拮抗瘦素及提高脂联素水平的药物可能成为治疗妊娠糖尿病的一种方案。