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目的探讨内脏脂肪素(Visfatin)与妊娠期糖尿病糖脂代谢的关系。方法选取2010年1月—2011年10月参照ADA标准诊断为GDM 38例,另选35名正常孕妇做对照组,分别测定两组分娩前空腹血糖(FPG)、空腹胰岛素(Fins)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇值(HDL-C)和Visfatin值,并计算胰岛素抵抗指数(HOMA-IR)。结果 GDM组血浆Visfatin水平明显高于正常对照组(P<0.01)。GDM组FPG、Fins、TG、LDL-C、HbA1c及HOMA-IR均高于正常对照组(P均<0.05),而HDL-C低于正常对照组(P<0.05),但两组的TC水平差异无统计学意义(P>0.05)。相关性分析表明:正常对照组分娩前Visfatin与空腹血糖和HOMA-IR以及TG均呈负相关(P<0.05),与HDL-C呈正相关(P<0.05),而GDM组分娩前Visfatin与上述指标之间无相关性,但与孕期体重增加量和分娩时BMI呈正相关(P<0.05)。结论 Visfatin参与正常妊娠期血糖、血脂代谢调节,并可能与GDM糖脂代谢紊乱有关。
Objective To investigate the relationship between visfatin and glucose and lipid metabolism in gestational diabetes mellitus. Methods 38 patients with GDM diagnosed by ADA criteria from January 2010 to October 2011 were selected and 35 normal pregnant women were selected as the control group. The levels of fasting blood glucose (FPG), fasting insulin (Fins), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and Visfatin values were calculated and insulin resistance index -IR). Results Plasma Visfatin level in GDM group was significantly higher than that in normal control group (P <0.01). The levels of FPG, Fins, TG, LDL-C, HbA1c and HOMA-IR in GDM group were significantly higher than those in normal control group (all P <0.05), but HDL-C was lower than that in normal control group The difference was not statistically significant (P> 0.05). Correlation analysis showed that Visfatin was negatively correlated with fasting plasma glucose, HOMA-IR and TG before delivery (P <0.05) and positively correlated with HDL-C (P <0.05) There was no correlation between the indexes, but positively correlated with weight gain during pregnancy and BMI at delivery (P <0.05). Conclusion Visfatin is involved in the regulation of blood glucose and lipid metabolism during normal pregnancy and may be related to the disorder of glucose and lipid metabolism in GDM.