摘要
目的研究妊娠期糖尿病（GDM）孕妇妊娠中期血清内脂素（SC）、趋化素（SV）、铁蛋白（SF）与GDM发病风险的关系。方法按巢式病例对照研究的方法选出2016年1月于复旦大学附属妇产科医院首次产检的300例孕妇作为观察队列，收集临床信息和妊娠13-17周的血清标本。随访对象至妊娠24-28周行75g15服葡萄糖耐量试验检出GDM孕妇42例，筛选出与之年龄匹配的孕妇90名作为对照组。检测两组孕妇SC、SV、SF及生化指标等。数据采用i-4-s或中位数（四分位间距）或百分比表示，采用t检验、Wilcoxon秩和检验、方差分析、Kruskal-Wallis检验、χ^2检验、Spearman等级相关分析、Logistic回归分析对数据进行统计学处理。结果（1）GDM孕妇SCf（83＋14）比（74＋12）μg／L，t=3．628，P〈0.001]与SV[53（88）比27（90）μg／L，H=2．787，P=0.0051明显高于对照组，SF[65（67）比62（53）μg／L，H=0．269，P=0．788]差异无统计学意义。（2）SV（r=0．058，P=0．512）、SC（r=0.035，P=0．693）与SF无相关性。sc与糖负荷后1h血糖（r=0．267，P=0．002）及糖负荷后2h血糖（r=0．212，P=0．015）呈正相关。SV与OGTT空腹血糖（r=0．180，P=0.039）呈正相关。（3）SC与GDM发病风险升高正相关，校正年龄、体质指数、空腹血糖、同型半胱氨酸、高密度脂蛋白胆固醇后，OR（95％CI）：1．069（1．029-1．112），P=0.001。结论孕妇GDM妊娠13-17周SC和SV水平升高，SC是GDM的独立危险因子，但均与SF无相关性。
Objective To assess the relationship between serum chemerin, visfatin, ferritin and the risk of gestational diabetes mellitus （GDM）. Methods According to nested case-control study design, a total of 300 pregnant women who took prenatal care in Obstetrics and Gynecology Hospital of Fudan University were chosen as the cohort, clinical information and serum samples during 13 to 17 weeks were collected. A total of 42 women with GDM who were tested by 75 g oral glucose tolerance test （OGTT） during 24 to 28 weeks of pregnancy and 90 age-matched normal women were screened. Serum levels of ehemerin, visfatin, ferritin and other indexes were determined. Data were expressed as ± s or median （interquartile interval）, and were analyzed using student＇s t-test, Wilcoxon rank-sum test, one-way ANOVA, Kruskal- Wallis test, Chi-square test, Pearson correlation and Logistic regression accordingly. Results （1） Serum concentrations of chemerin [（83±14） vs （74±12） μg/L, t=- 3.628, P〈0.001] and visfatin [53（88） vs 27（90） μg/L, H= - 2.787, P=0.005] were significantly higher than those in the control group. Serum ferritin [65（67） vs 62（53） Ixg/L, H=- 0.269, P=0.788] showed no difference between the two groups. （2） Ferritin was demonstrated unrelated to visfiin （r=0.058, P=0.512） and chemerin （r=0.035, P=0.693）. There was a positive correlation between chemerin and one hour postprandial plasma glucose （r=0.267, P=0.002） and two hour postprandial plasma glucose （r=0.212, P=0.015）. There was a positive con＇elation between visfatin and OGTT fasting plasma glucose （r=0.180, P=0.039）. （3） Chemerin was positively associated with GDM risk even after adjustment for age, body mass index, fasting plasma glucose, homoeysteine and high-density lipoprotein-cholesterol, OR （95%C/） were 1.069（1.029-1.112）, P=0.001. Conclusions Serum concentrations of chemerin and visfatin in early midtrimester are significantly higher in GDM and are irrelevant to ferritin. Elevated levels of chemerin during 13 to 17 weeks of pregnancy is an independent risk factor for GDM.
作者
刘俊秀
程琰
贺木兰
张庆英
李婷婷
吴奎
陆静波
程海东
Liu Junxiu;Cheng Yan;He Mulan;Zhang Qingying;Li Tingting;Wu Kui;Lu Jingbo;Cheng Haidong(Department of Obstetrics,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2018年第9期601-605,共5页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家自然科学基金（81471469）
上海市科委医学与农业领域科技支撑项目（15411952900）
上海市科委医学引导类项目（14411965600）
关键词
糖尿病
妊娠
趋化因子类
铁蛋白类
内脂素
Diabetes
gestational
Chemotactic factors
Ferritins
Visfatin
