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目的:探讨脐血脂联素水平与妊娠期糖尿病巨大儿发生的关系。方法:选择孕期诊为GDM并且血糖控制满意的孕妇236例作为研究组,同期正常妊娠的孕妇251例作为对照组,追踪所有孕妇分娩的新生儿体重,新生儿出生体重≥4.0 kg为巨大儿。所有新生儿出生后即抽取脐血测脂联素水平,并记录出生体重、身长、肩围及腹壁皮下脂肪厚度,计算胰岛素抵抗指数HOMA-IR和新生儿营养指数RI。结果:GDM组巨大儿出生体重、RI及HOMA-IR均高于正常对照组巨大儿,差异有统计学意义(P<0.05),GDM组脐血脂联素水平明显低于对照组(P<0.05)。GDM组巨大儿脐血脂联素与出生体重、RI成负相关关系(P<0.05),与HOMA-IR成正相关关系(P<0.05),而与巨大儿身长、头围、肩围及腹壁皮下脂肪厚度不相关(P>0.05)。结论:脐血脂联素与胎儿宫内生长发育关系密切,脐血APN水平可直接反映巨大儿的体脂含量。
Objective: To investigate the relationship between umbilical blood adiponectin levels and the occurrence of macrosomia in gestational diabetes mellitus. Methods: 236 pregnant women who were diagnosed as GDM during pregnancy and whose blood glucose was satisfactorily controlled were selected as the study group. 251 pregnant women with normal pregnancy were selected as the control group to track the weight of newborn babies born in all pregnant women. Umbilical cord blood was taken to measure adiponectin level after birth, and birth weight, body length, shoulder circumference and abdominal subcutaneous fat thickness were recorded. Insulin resistance index (HOMA-IR) and neonatal nutritional index (RI) were calculated. Results: The birth weight, RI and HOMA-IR of macrosomia in GDM group were significantly higher than those in normal control macrophages (P <0.05). The level of adiponectin in GDM group was significantly lower than that in control group (P <0.05) ). There was a positive correlation between serum adiponectin and birth weight and RI in GDM group (P <0.05), and a positive correlation with HOMA-IR (P <0.05), but not with body length, head circumference, shoulder circumference and abdominal wall Fat thickness was not related (P> 0.05). Conclusion: Cord blood adiponectin and fetal intrauterine growth and development are closely related, cord blood APN levels can directly reflect the body fat of macrosomia.