妊娠糖尿病患者胰岛β细胞功能与相关脂肪细胞因子的关系_临床医学论文.docVIP

妊娠糖尿病患者胰岛β细胞功能与相关脂肪细胞因子的关系_临床医学论文 妊娠糖尿病患者胰岛β细胞功能与相关脂肪细胞因子的关系_临床医学论文 作者：施琦阳，苏维娜，黄凤凰，陈频 【摘要】 　　目的 观察妊娠糖尿病（GDM）患者胰岛β细胞功能与脂联素、内脂素、瘦素、抵抗素等脂肪细胞因子的关系。 方法 入选GDM患者（GDM组，n=56）、正常妊娠妇女（妊娠组，n=60）和正常育龄妇女（对照组，n=50）为受试者，测定3组研究对象的血糖(FBG)、血脂、胰岛素(FINS)等生化指标和血脂联素、内脂素、瘦素和抵抗素的水平。用稳态模型胰岛素抵抗指数（HOMA）、胰岛素分泌指数（HOMA）和胰岛素敏感指数（ISI）评价胰岛β细胞功能。 结果 与对照组和妊娠组比较，GDM组患者的脂联素和内脂素水平下降，瘦素和抵抗素水平升高（P＜0.05），同时FBG、FINS和HOMA升高，HOMA和ISI下降（P＜0.05）。Logistic回归分析显示，影响GDM患者胰岛β细胞功能的因素有年龄、孕期、体质量指数(BMI)、FBG、FINS、脂联素、内脂素、瘦素和抵抗素（P＜0.05或0.01）。 结论 GDM患者胰岛β细胞功能的受损可能与脂肪细胞因子分泌失衡有关。 【关键词】 糖尿病，妊娠； 胰岛素； 胰岛； 瘦素； 细胞因子类； 激素类，异位； 胰岛素抗药性 　　ABSTRACT: Objective To study the relathionship between insulin, β cells funtion and related adipocyte factors(adiponectin, visfatin, leptin and resistin) in gestational diabetes mellitus patients. Methods Gestational diabetes mellitus patients(GDM group, n=56), normal pregnant women(normal pregnant group, n=60) and healthy women(control group, n=50) were enrolled. Serum glucose, lipids, insulin, adiponectin, visfatin, leptin and resistin were measured among the three groups. Insulin resistance index(HOMAIR), insulin secretion index(HOMAβ) and insulin sensitivity index(ISI) were calculated.Results The levels of adiponectin and visfatin were decreased, leptin and resistin were increased in GDM group compared with those in normal pregnant group and control group(P＜0.05), while FBG, FINS and HOMA＜0.05). Logistic regression analysis showed that age, duration of pregnancy, BMI, FBG, FINS, adiponectin, visfatin, leptin, resistin and impaired insulin, β cells funtion of gestational diabetes mellitus patients had significant correlation (P＜0.05 or 0.01). Conclusion Impaired insulin, β cells funtion of gestational diabetes mellitus patients may be related to secretion imbalance of adipocyte factors. 　　KEY WORDS: diabetes, gestational; insulin; islets of langerhans; leptin; cytokines; hormones, ectopic; insulin resistance 　　妊娠糖尿病（gestational diabites mellitus, GDM）是妊娠期间发生的糖代谢异常状态，临床并发症比较多，是一种严重危害母婴身心健康的疾