网膜素在妊娠糖尿病患者中表达的临床意义

摘要

Objective It is to investigate the clinical significance of expression of serum omentin in patients with gestation -al diabetes mellitus ( GDM) .Methods 88 patients with GDM and 72 normal control ( NGT) were enrolled in this study .The patients were divided into 2 groups:GDMA1 group (n=54), GDMA2 group (n=34) according to the OGTT test and their treatment.The levels of fasting blood glucose(FBG), fasting insulin(FINS), serum omentin, TNF-αwere determined and HOMA-IR were calculated .The pregnancy outcomes were compared in three groups .Results More complications were dis-played in the GDMA2 group(P<0.05);Compared to the NGT group, GDMA1 group showed a higher HOMA -IR and a low-er serum omentin levels (P<0.05).Moreover, some indexes, like FBG, HOMA-IR, FINS and TNF-α, were much high-er in GDMA2 group, except a much lower serum omentin levels (P<0.01);Serum omentin levels were negatively correlated with HOMA-IR among all patients (r=-0.819, P<0.01); Subgroup analysis for GDMA2 group, serum omentin levels were also negatively correlated with FINS and TNF -α(r=-0.723, r=-0.682, P<0.01).Conclusion Serum omentin might be a new and sensitive marker for diagnosing GDM;the decreased serum omentin might be due to the insulin resistance .%目的：探讨不同糖耐量孕妇血清网膜素表达的临床意义。方法选择88例糖代谢异常孕妇及72例正常孕妇（ NGT）。根据OGTT试验及治疗情况将糖代谢异常孕妇分为妊娠糖尿病（ GDM ） A1级组54例、GDMA2组34例。测定3组空腹血糖（ FBG ）、胰岛素（ FINS）、网膜素及TNF-α浓度，计算出胰岛素抵抗指数（ HOMA-IR），比较3组妊娠结局。结果 GDMA2组显示出更高的母儿并发症（P＜0．05）；相比NGT组，GDMA1组HOMA-IR升高及网膜素降低（P均＜0．05），GDMA2组FBG、HOMA-IR、FINS及TNF-α均显著升高，而网膜素水平进一步降低（ P＜0．01）；所有患者血清网膜素与HOMA-IR呈负相关（ r＝-0.819，P＜0．01）；而在GDMA2组血清网膜素还与FINS、TNF-α呈负相关（r＝-0．723，P＜0.01；r＝-0．682，P＜0．01）。结论网膜素可能是一个敏感的GDM的诊断指标，GDM中的高胰岛素抵抗状态可能是引起网膜素升高的因素。