国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (2): 197-200.

• 论著 • 上一篇    下一篇

妊娠期血浆脂联素水平变化与妊娠期糖尿病的相关性研究

于宁，陈叙，张志坤   

  1. 300100 天津市中心妇产科医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-04-15 发布日期:2014-04-15
  • 通讯作者: 陈叙

Alteration of Maternal Plasma Adiponectin Concentration in Pregnancy and Its Correlation with Gestational Diabetes Mellitus

YU Ning，CHEN Xu，ZHANG Zhi-kun   

  1. Tianjin Central Hospital of Gynecology Obstetrics，300100 Tianjin，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-04-15 Online:2014-04-15
  • Contact: CHEN Xu

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摘要： 目的：探讨血浆脂联素与妊娠期糖尿病（GDM）的相关性，及妊娠期血浆脂联素水平变化对GDM发病风险及预后的预测价值。方法：采用巢式病例对照研究留取1 000例妊娠早期于天津市中心妇产科医院门诊产检的妊娠妇女空腹血标本，选取最终诊断为GDM者91例，其中未使用胰岛素治疗者60例为A1组，使用胰岛素治疗者31例为A2组，并随机选取同期糖耐量正常（NGT）妊娠妇女32例作为对照组。所有入选病例均随访至分娩，通过酶联免疫吸附试验（ELISA）检测3组病例妊娠早、中、晚期血浆及脐血中脂联素水平，免疫组化法检测3组病例胎盘组织中脂联素蛋白表达。结果：妊娠不同时期A1组和A2组血浆脂联素水平均低于NGT组，差异有统计学意义（P＜0.01，P＜0.01，P＜0.05），而A1、A2组之间差异无统计学意义（P＞0.05）；妊娠早期血浆脂联素水平高于妊娠中、晚期，差异有统计学意义（均P＜0.01）；3组脐血标本中血浆脂联素水平比较差异无统计学意义（P＞0.05）；A1组和A2组胎盘组织中脂联素蛋白表达低于NGT组，差异有统计学意义（P＜0.05）。结论：血浆脂联素水平降低与GDM发病有关，并且在妊娠早、中期即可表现出差异性，从而可达到对GDM的发病风险进行早期预测及治疗。但该脂肪因子对胎儿宫内生长发育的影响尚需进一步研究。

关键词: 脂联素, 糖尿病, 妊娠, 胰岛素抗药性, 病例对照研究

Abstract: Objective：To investigate the dynamic changes of adiponectin and the correlation with gestational diabetes mellitus（GDM），and its prediction of the risk and prognosis in GDM. Methods：A nested case-control study was undertaken. 91 women with GDM，including 60 cases without insulin treatment（A1） and 31 cases with insulin treatment（A2）. 32 women with normal glucose tolerance in control group. Maternal and umbilical plasma adiponectin were determined by enzyme linked immunosorbent assay（ELISA）. The expression of adiponectin protein in placental was measured by immunohistochemistry. Results： To compare with controls，maternal adiponectin levels were lower in women with GDM at different stages of pregnancy（P＜0.01，P＜0.01，P＜0.05）. Plasma adiponectin levels were significantly decreased in the second and the third trimester（both P＜0.01）. Umbilical plasma adiponectin levels were not significantly different among 3 groups（P＞0.05）. The expression of adiponectin protein in GDM was much lower than normal pregnant women（P＜0.05）. Conclusions：Hypoadiponectinaemia may be relevant to the pathogenesis of GDM. And this alteration occurs in the first and second trimester. Therefore，detecting adiponectin concentration may predict the risk of GDM at an early stage of pregnancy. Further studies are required to verify whether the cytokine plays a role in fetal intrauterine growth.

Key words: Adiponectin, Diabetes, gestational, Insulin resistance, Case-control studies