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目的分析妊娠期糖尿病(GDM)母胎血清脂肪因子水平的差异及与胎儿代谢关系。方法选取31例GDM患者作为观察组,选取同期31例正常妊娠妇女作为对照组,采用ELISA法检测血清脂肪因子[(白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、内脂素(Visfatin,VF)、视黄醇结合蛋白-4(RBP4)、脂联素(Adiponectin,ADPN)]水平,采用免疫放射定量法检测胰岛素(Insulin,INS)水平,对比各指标水平,并分析母体血清脂肪因子与胎儿糖代谢指标间相关性。结果观察组母体RBP4水平高于胎儿,差异具有统计学意义(P<0.05);观察组母体IL-6、TNF-α、VF、RBP4、ADPN、INS等指标水平与对照组相比,差异具有统计学意义(P<0.05);观察组胎儿IL-6、TNF-α、INS水平高于对照组胎儿,ADPN水平低于对照组胎儿,差异具有统计学意义(P<0.05);RBP4与INS呈明显正相关(r=0.316,P<0.05)。结论妊娠期糖尿病母体血清脂肪因子中视黄醇结合蛋白-4高于胎儿,提示胎儿针对母体代谢状态可能存在自身调节机制。
Objective To analyze the difference of serum adiponectin level in gestational diabetes mellitus (GDM) and its relationship with fetal metabolism. Methods Totally 31 cases of GDM patients were selected as the observation group, and 31 normal pregnant women were selected as the control group. Serum levels of adiponectin (IL-6, TNF-α , Visfatin (VF), retinol binding protein-4 (RBP4) and adiponectin (ADPN) were detected by radioimmunoassay. Insulin (INS) (P <0.05). The levels of IL-6, TNF-α and VF in the observation group were significantly higher than those in the fetus , RBP4, ADPN and INS were significantly higher than those in the control group (P <0.05). The levels of IL-6, TNF-α and INS in the observation group were higher than those in the control group, and the levels of ADPN in the observation group were lower than those in the control group (P <0.05). RBP4 was positively correlated with INS (r = 0.316, P <0.05) .Conclusion Retinol binding protein-4 in maternal serum adipokine of gestational diabetes is higher than that of fetus, Suggesting that the fetus may have its own regulatory mechanism for maternal metabolic status.