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目的:探讨妊娠期糖尿病(GDM)早期肾损害与高敏C-反应蛋白(Hs-CRP)及脂联素(APN)的相关性。方法:选取2013年2月~2014年2月在该院门诊进行常规产前检查及住院分娩的GDM患者58例作为GDM组,另外选择30例糖耐量正常的孕妇作为对照组(NC组)。将GDM患者分为正常尿蛋白组20例〔尿微量白蛋白(MAU)<20μg/min〕,微量尿蛋白组24例(尿MAU 20~200μg/min),临床尿蛋白组14例(尿MAU>200μg/min)。测定各组Hs-CRP、APN、MAU等。结果:GDM组APN水平明显低于NC组,差异有统计学意义(P<0.01),Hs-CRP、MAU明显高于NC组,差异有统计学意义(P<0.05)。随着病情加重,APN逐渐减低,Hs-CRP逐渐升高,差异有统计学意义(P<0.05)。MAU水平与血清APN呈负相关(r=-0.44,P<0.05),与糖化血红蛋白(Hb Alc)、Hs-CRP均呈正相关(r=0.31,0.42,均P<0.05)。结论:Hs-CRP、APN参与GDM的发生、发展,并且与GDM患者MAU的发生密切相关。
Objective: To investigate the relationship between early renal damage in gestational diabetes mellitus (GDM) and high-sensitivity C-reactive protein (Hs-CRP) and adiponectin (APN). Methods: From February 2013 to February 2014, 58 patients with GDM undergoing routine antenatal examination and hospital delivery were selected as GDM group. Another 30 pregnant women with normal glucose tolerance were selected as the control group (NC group). GDM patients were divided into normal urinary protein group of 20 cases (urinary microalbuminuria (MAU) <20μg / min], microalbuminuria in 24 cases (urinary MAU 20 ~ 200μg / min), clinical urinary protein group of 14 patients > 200 μg / min). Hs-CRP, APN, MAU, etc. were determined in each group. Results: The APN level in GDM group was significantly lower than that in NC group (P <0.01). The Hs-CRP and MAU levels in GDM group were significantly higher than those in NC group (P <0.05). With the aggravation of disease, APN gradually decreased and Hs-CRP gradually increased, the difference was statistically significant (P <0.05). MAU levels were negatively correlated with serum APN (r = -0.44, P <0.05), but positively correlated with Hb Alc and Hs-CRP (r = 0.31,0.42, all P <0.05). Conclusion: Hs-CRP and APN are involved in the occurrence and development of GDM, and are closely related to the occurrence of MAU in GDM patients.