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目的分析妊娠期糖尿病(GDM)产妇产后6~8周的血清脂联素(APN)及C反应蛋白(CRP)水平。方法确诊GDM产妇61例,产后6~8周依据口服葡萄糖耐量试验(OGTT)分为糖耐量减低(A组,19例)和糖耐量恢复正常(B组,42例),另选20例正常妊娠产后6~8周产妇作为对照(C组),测定血清APN和CRP水平,比较三组稳态模型指数(HOMA-β)和HOMA-IR。结果A、B组APN低于C组,且A组亦低于B组(P<0.05)。A组空腹胰岛素(FIns)、CRP和HOMA-IR高于B、C组(P<0.05),而HOMA-β低于B、C组(P<0.05)。GDM产妇产后APN与孕晚期BMI、FIns、HOMA-IR呈负相关(r=-0.431、-0.187、-0.243,P<0.05),与HOMA-β呈正相关(r=0.325,P<0.01);CRP与FIns、HOMA-IR呈正相关(r=0.292、0.362,P<0.01)。结论GDM产妇产后糖代谢持续异常者的APN水平低于糖代谢恢复正常者,而CRP水平高于糖代谢恢复正常者。APN及CRP是反映GDM产妇产后糖代谢状态的敏感指标。
Objective To analyze the levels of serum adiponectin (APN) and C-reactive protein (CRP) at 6-8 weeks postpartum in gestational diabetes mellitus (GDM). Methods Totally 61 GDM mothers were diagnosed, and 6 to 8 weeks postpartum were divided into two groups according to the oral glucose tolerance test (OGTT): impaired glucose tolerance (group A, n = 19) and normal glucose tolerance (group B, n = 42) Serum APN and CRP levels were measured at 6 to 8 weeks postpartum in pregnant women as controls (group C). HOMA-β and HOMA-IR were compared between the three groups. Results APN in group A and group B were lower than group C, and group A was also lower than group B (P <0.05). FIns, CRP and HOMA-IR of group A were higher than those of group B and C (P <0.05), while HOMA-β was lower than group B and C (P <0.05). The postpartum APN of GDM was negatively correlated with the levels of BMI, FIns and HOMA - IR in the third trimester (r = -0.431, -0.187, -0.243, P <0.05), and positively correlated with HOMA - β CRP was positively correlated with FIns and HOMA-IR (r = 0.292,0.362, P <0.01). Conclusions The level of APN in patients with persistent abnormal glucose metabolism after delivery of GDM is lower than those with normal glucose metabolism, while the level of CRP is higher than those with normal glucose metabolism. APN and CRP are sensitive indicators of postpartum glucose metabolism in GDM mothers.