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目的了解妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇在不同孕周血清Chemerin水平的变化及其临床意义。方法采用酶联免疫吸附法测定171例GDM患者(GDM组)及42例糖耐量正常孕妇(对照组)孕中期及孕晚期的血清Chemerin水平,同时测定受试者空腹血糖(FPG)、空腹胰岛素(FINS)、不同孕期的BMI数值等,计算胰岛素抵抗指数(HOMA-IR)。结果 GDM组在孕中期及孕晚期时的空腹胰岛素、HOMA-IR及Chemerin均明显高于对照组(P<0.05)。两组孕妇血清Chemerin在孕中期及孕晚期时与空腹胰岛素及HOMA-IR均呈正相关(P<0.05),其中GDM组呈高度正相关,对照组呈中度正相关。而两组孕妇血清Chemerin在孕中晚期时与空腹血糖、服糖后1h血糖、服糖后2h血糖、BMI值均低度相关(|r|<0.05)、不相关(|r|<0.3)或无统计学意义(P>0.05)。GDM组孕妇空腹胰岛素在孕中期和孕晚期对比,检验结果无统计学意义(P>0.05),而Chemerin在孕晚期时较孕中期数值升高(P<0.01),空腹血糖和HOMA-IR在孕晚期时较孕中期数值降低(P<0.01)。正常组孕妇四项数值在孕中期和孕晚期对比检验结果均无统计学意义(P>0.05)。结论Chemerin与胰岛素抵抗及GDM发病密切相关,且Chemerin数值不受即时血糖高低的干扰,能反映出GDM孕妇的胰岛素敏感状态,可能对GDM孕妇是否将来易患2型糖尿病起预测指标的作用。
Objective To investigate the changes of serum Chemerin in pregnant women with gestational diabetes mellitus (gestational diabetes mellitus, gestational diabetes mellitus, gestational diabetes mellitus at different gestational weeks and its clinical significance. Methods Serum Chemerin levels in 171 GDM patients (GDM group) and 42 normal pregnant women with glucose tolerance (control group) were measured by enzyme-linked immunosorbent assay (ELISA) in the second trimester of pregnancy and the third trimester of pregnancy. The fasting blood glucose (FPG), fasting insulin (FINS), different pregnancy BMI values, calculate the insulin resistance index (HOMA-IR). Results Fasting insulin, HOMA-IR and Chemerin in GDM group were significantly higher than those in control group (P <0.05). Serum Chemerin in the two groups had a positive correlation with fasting insulin and HOMA-IR at the second trimester and the third trimester (P <0.05). There was a positive correlation between Chemerin and the control group. Serum Chemerin in the two groups of pregnant women had a low degree of correlation (| r | <0.05) with fasting blood glucose, blood glucose at 1h after oral glucose administration, Or no statistical significance (P> 0.05). There was no significant difference between fasting insulin and fasting insulin in pregnant women in GDM group (P> 0.05), while Chemerin increased in mid-third trimester (P <0.01). Fasting plasma glucose and HOMA-IR Lower third trimester than the third trimester (P <0.01). The normal pregnant women in the four values in the second trimester and third trimester contrast test results were not statistically significant (P> 0.05). Conclusions Chemerin is closely related to insulin resistance and GDM, and Chemerin does not interfere with the instantaneous blood glucose level. It can reflect the insulin sensitivity status of GDM pregnant women and may predict the future predisposition of GDM to type 2 diabetes.