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目的探讨C肽、糖化血红蛋白(glycosylated hemoglobin,HbA1c)及脂联素对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者产后随访的价值。方法 114例GDM患者为观察组,同期正常妊娠40例产妇为对照组,比较2组产后42d、6个月、12个月脂联素、HbA1c及C肽水平。结果观察组产后42d、6个月、12个月C肽水平[(0.34±0.27)、(0.46±0.21)、(0.58±0.21)nmol/L]高于对照组[(0.30±0.26)、(0.39±0.26)、(0.41±0.27)nmol/L](P<0.05),脂联素水平[(7.68±2.01)、(7.34±1.96)、(7.44±1.91)mg/L]低于对照组[(7.86±2.03)、(7.75±2.05)、(7.84±2.02)mg/L](P<0.05),产后42d HbA1c水平[(6.5±0.4)%]高于对照组[(5.7±0.3)%],产后6、12个月HbA1c[(5.8±0.3)%、(5.4±0.2)%]与对照组[(5.6±0.2)%、(5.5±0.2)%]比较差异均无统计学意义(P>0.05)。结论监测C肽、HbA1c及脂联素水平可作为筛查GDM患者产后糖代谢异常或糖尿病的有效指标。
Objective To investigate the value of C-peptide, glycosylated hemoglobin (HbA1c) and adiponectin in postpartum follow-up of gestational diabetes mellitus (GDM) patients. Methods One hundred and seventy four patients with GDM were selected as the observation group. Forty pregnant women of the same period as control group, the levels of adiponectin, HbA1c and C-peptide were compared between the two groups at 42d, 6th and 12th postpartum. Results The levels of C-peptide in the observation group were significantly higher than those in the control group [(0.30 ± 0.26), (0.34 ± 0.27), (0.46 ± 0.21) and (0.58 ± 0.21) nmol / L] (0.39 ± 0.26), (0.41 ± 0.27) nmol / L, P <0.05). The levels of adiponectin were lower than those of the control group [(7.68 ± 2.01), (7.34 ± 1.96), (7.44 ± 1.91) mg / L] (P <0.05). The level of HbA1c at postnatal day 42 ([6.5 ± 0.4]%] was significantly higher than that in control group [(5.7 ± 0.3) vs (7.8 ± 2.02) mg / %], There was no significant difference in HbA1c [(5.8 ± 0.3)%, (5.4 ± 0.2)%] and control group [(5.6 ± 0.2)%, (5.5 ± 0.2)%] (P> 0.05). Conclusion Monitoring the levels of C-peptide, HbA1c and adiponectin can be used as an effective index for screening abnormal glucose metabolism or diabetes after delivery in GDM patients.