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目的探讨妊娠期糖尿病患者血清瘦素(Leptin)与胰岛素抵抗水平、肿瘤坏死因子的关系。方法2002年1月至2005年2月解放军181医院对32例妊娠期糖尿病患者(GDM)为观察组,随机选择同期门诊及住院36例糖耐量正常妊娠妇女为对照组,均进行75g葡萄糖耐量试验(OGTT),同时测定空腹血清瘦素(leptin)、肿瘤坏死因子(INFα)、胰岛素(FINS),稳态模型(HOMA)计算胰岛素抵抗指数(HOMAIR),并应用pearson分析妊娠期糖尿病患者胰岛素抵抗与瘦素、INFα、空腹胰岛素、体重指数(BMI)的关系。结果观察组血清瘦素、INFα、FINS及胰岛素抵抗指数均明显高于对照组(P<0.05或P<0.01);血清瘦素、INFα、FINS、BMI与HOMAIR呈正相关(P<0.01)。结论瘦素、肿瘤坏死因子是影响妊娠期糖尿病患者胰岛素抵抗的重要因素之一。
Objective To investigate the relationship between serum leptin and insulin resistance and tumor necrosis factor (TNF) in patients with gestational diabetes mellitus. METHODS: From January 2002 to February 2005, 181 pregnant women with gestational diabetes mellitus (GDM) in 181 hospital of People’s Liberation Army (PLA) were randomly divided into observation group, 36 outpatients with normal glucose tolerance and inpatients with normal glucose tolerance were selected as control group, and 75g glucose tolerance test (OGTT), fasting serum leptin, tumor necrosis factor (INFα), insulin (FINS) and homeostasis model (HOMA) were measured to calculate insulin resistance index (HOMAIR). Pearson analysis was used to analyze insulin resistance in gestational diabetes mellitus And leptin, INFα, fasting insulin, body mass index (BMI). Results The levels of serum leptin, INFα, FINS and insulin resistance in observation group were significantly higher than those in control group (P <0.05 or P <0.01). Serum leptin, INFα, FINS and BMI were positively correlated with HOMAIR (P <0.01). Conclusion Leptin and tumor necrosis factor are one of the important factors that affect insulin resistance in gestational diabetes mellitus.