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妊娠期糖尿病患者内脏脂肪素水平与胰岛素抵抗的关系

华绍芳1,韩玉环2,匡德凤1   

  1. 1. 天津医科大学第二医院
    2. 天津医科大学第二医院产科
  • 收稿日期:2010-12-07 修回日期:2011-03-03 出版日期:2011-07-15 发布日期:2011-07-15
  • 通讯作者: 华绍芳

The Relationship Between Visfatin Level and Insulin Resistant Degree In Gestational Diabetic Patients

  • Received:2010-12-07 Revised:2011-03-03 Published:2011-07-15 Online:2011-07-15
  • Contact: Shao-Fang HUA

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摘要： 目的：探讨妊娠期糖尿病患者血清内脏脂肪素（visfatin）表达水平差异及其与胰岛素抵抗的相关性。方法：106例研究对象根据ADA标准分为三组：妊娠期糖尿病组（GDM，n=50）、妊娠期糖耐量受损组（GIGT，n=24）以及糖耐量正常组（NGT，n= 32）。收集各组临床、围产资料；酶联免疫吸附法检测血清visfatin水平，化学发光法检测空腹血清胰岛素水平。比较不同组别visfatin水平的差异，并分析其与体质指数(BMI)、血糖血脂代谢指标、胰岛素抵抗指数(HOMA-IR)等的相关性。结果：GDM组血清visfatin水平（84.04±22.15 ng/ml）高于GIGT组（65.71±13.38 ng/ml）及NGT组（56.11±10.39 ng/ml）（F=26.562,P=0.001）。三组血清胰岛素水平也存在差异，GDM、GIGT及NGT组分别是27.91±10.31mIu/L、26.94±6.69mIu/L以及22.32±3.37mIu/L，差异有显著性（F=4.984,P=0.009）。血清visfatin水平与胰岛素水平、胰岛素抵抗指数均呈显著正相关性（r=0.636, 0.738, 均P= 0.001）；visfatin水平与孕妇总胆固醇、三酰甘油以及糖化血红蛋白水平也具有相关性。结论 妊娠妇女内脏脂肪素高水平表达增加了组织胰岛素抵抗的程度，通过影响糖脂代谢参与了妊娠期糖尿病的发生。

关键词: 妊娠期糖尿病, 内脏脂肪素, 胰岛素抵抗

Abstract: To measure the serum visfatin level in gestational diabetic patients and study the correlation between visfatin level and insulin resistant degree. Methods: According to the ADA standard, 106 pregnant women were divided into three groups. Gestational diabetes mellitus group (GDM, n=50), the group with gestational impaired glucose tolerance (GIGT, n=24), the control group with normal glucose tolerance (NGT, n=32). Recorded the clinical and perinatal data. Serum visfatin levels were measured by ELISA method and insulin levels were measured bychemiluminescence. Analyze the difference among these groups and study the relationship between visfatin and body mass index, , insulin-resistant degree. Results: The serum visfatin level in GDM group（84.04±22.15 ng/ml）was higher than GIGT group（65.71±13.38 ng/ml） and NGT group （56.11±10.39 ng/ml）（F=26.562, P=0.001）。There were also difference in serum insulin level among three groups, the value in GDM, GIGT and NGT group was 27.91±10.31mIu/L, 26.94±6.69mIu/L and 22.32±3.37mIu/L（F=4.984,P=0.009）. Serum visfatin level was positively related with insulin level and HOMA-IR （r=0.636, 0.738, all P= 0.001）.There were also relationship between visfatin level and TC, TG, HbA1C value. Conclusion: High-expressed visfatin increases the insulin-resistance in pregnant women. Visfatin participates the metabolic disturbance in glucose and lipid, this maybe a mechanism of GDM occurrence.

Key words: gestational diabetes mellitus, visfatin, insulin-resistance