妊娠肥胖、妊娠期糖尿病孕妇网膜素水平变化

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目的探讨妊娠肥胖、妊娠期糖尿病(GDM)患者血清网膜素(Omentin)水平变化及其与脂联素(APN)、视黄醇结合蛋白-4(RBP-4)的相关性。方法采用酶联免疫吸附法检测38例孕前肥胖的GDM孕妇(A组)、41例孕前非肥胖的GDM孕妇(B组)、39例单纯肥胖孕妇(C组)、44例正常健康孕妇(D组)血清omentin、APN、RBP-4水平;同时测定所有受试者的糖、脂生化指标,并计算胰岛素抵抗指数(HOMA-IR)。结果 (1)GDM孕妇TG、FPG、FINS、HOMA-IR水平均高于正常对照组,HDL-C水平低于正常对照组(P<0.05)。A、C组孕妇FINS、HOMA-IR水平分别较B、D组高(P<0.05)。(2)GDM孕妇omentin、APN水平低于非GDM孕妇(P<0.001),C组孕妇omentin、APN水平低于D组孕妇(P<0.01);A组RBP-4水平最高(P<0.05),C组RBP-4水平高于D组(P<0.001)。(3)血清网膜素水平与HDL-C、APN正相关,与TG、FPG、FINS、HOMA-IR及RBP-4负相关(P<0.05)。(4)多元逐步回归分析显示FINS、APN是影响血清网膜素水平的重要因素(P<0.05)。结论 GDM孕妇及单纯肥胖孕妇存在糖、脂代谢异常,其血清omentin、APN水平降低,RBP-4水平升高,网膜素与糖、脂代谢指标及其他脂肪因子之间密切相关,共同参与肥胖及GDM的发生。 Objective To investigate the changes of serum retinin (Omentin) level and its correlation with adiponectin (APN) and retinol binding protein-4 (RBP-4) in patients with gestational obesity and gestational diabetes mellitus (GDM). Methods 38 pregnant women with pre-pregnancy obesity (group A), 41 pregnant women with non-obese GDM (group B), 39 simple obese pregnant women (group C) and 44 normal healthy pregnant women (group D) were enrolled in this study. Group) serum omentin, APN, RBP-4 levels; simultaneous determination of glucose and lipid biochemical indicators of all subjects, and calculate the insulin resistance index (HOMA-IR). Results (1) The levels of TG, FPG, FINS and HOMA-IR in GDM pregnant women were significantly higher than those in normal control group, while the levels of HDL-C were lower than those in normal control group (P <0.05). The levels of FINS and HOMA-IR in pregnant women in groups A and C were higher than those in groups B and D, respectively (P <0.05). (2) The levels of omentin and APN in GDM pregnant women were lower than those in non-GDM pregnant women (P <0.001), while the levels of omentin and APN in pregnant women in C group were lower than those in pregnant women in D group (P <0.01) , And the level of RBP-4 in group C was higher than that in group D (P <0.001). (3) The level of serum retinin was positively correlated with HDL-C and APN and negatively correlated with TG, FPG, FINS, HOMA-IR and RBP-4 (P <0.05). (4) Multiple stepwise regression analysis showed that FINS and APN were the important factors influencing serum retinin level (P <0.05). Conclusion GDM pregnant women and simple obese pregnant women have abnormal glucose and lipid metabolism, serum omentin and APN levels are decreased, RBP-4 levels are elevated, and the correlation between retinal and glucose, lipid metabolism indexes and other adipokines is closely related to participate in obesity And the occurrence of GDM.
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