妊娠期糖尿病胎儿相关指标与脂联素关系分析

刘萍　沈文广

[摘要] 目的 探讨妊娠期糖尿病胎儿脐血APN、新生儿体重、脐血糖化血红蛋白及脐血IR与脂联素的关系。 方法 回顾性分析2013年3～12月在我院住院足月分娩的孕妇91例，根据OGTT试验结果将患者分为两组，GDM组61例，NGT组30例，检测血清APN、FINS、FPG、HbA1C、脐血IR。 结果 GDM组胎儿脐血APN水平与NGT组比较明显较低，新生儿体重及脐血IR水平与NGT组比较明显较高，两组有显著性差异（P<0.05）；GDM组脐血糖化血红蛋白与NGT组比较稍高，但经统计学分析两组无显著性差异（P>0.05）；脐血APN与新生儿体重及脐血IR水平呈明显负相关（P<0.05）。 结论 GDM孕妇胎儿脂联素水平低于正常胎儿，新生儿体重及脐血IR水平与胎儿脂联素水平有关，有效的糖尿病管理有利于新生儿体重及脐血IR水平降低。

[关键词] 脂联素；妊娠期糖尿病；胎儿

[中图分类号] R714.256 [文献标识码] B [文章编号] 1673-9701（2014）27-0132-03

[Abstract] Objective To investigate the relationship of the gestational diabetes of fetal cord blood APN， birth weight， umbilical cord blood glycosylated hemoglobin IR and adiponectin. Methods 91 cases of pregnant women selected from March 2013 to December 2013 who came to our hospital for the term delivery were retrospective analyzed， they were divided into two groups according to the OGTT test results， there were 61 cases in GDM group， there were 30 cases in the NGT group. The serum APN， FINS， FPG， HbA1C， umbilical blood IR of two groups were detected. Results APN fetal cord blood levels of GDM group was significantly lower than that of NGT group， the birth weight and umbilical IR levels of GDM group were significantly higher than that of NGT group， there were significant differences（P<0.05）； The cord blood glycosylated hemoglobin level of GDM group was slightly higher than that of NGT group， but there were no no significant differences（P>0.05）； The cord blood APN was significant negative correlation with birth weight and umbilical IR levels（P<0.05）. Conclusion GDM pregnant women fetal adiponectin levels is lower than normal fetuses， birth weight and fetal cord blood IR adiponectin levels and the level of effective diabetes management in favor of birth weight and umbilical IR levels decreased.

[Key words] Adiponectin； Gestational diabetes； Fetus

妊娠期糖尿病（GDM）是指妊娠前糖代谢正常或有潜在糖耐量减退，在妊娠期才发现或发生的糖尿病[1]，近年来其发病率呈现逐年升高的趋势。脂联素是新近发现的脂肪细胞分泌的激素，具有增强胰岛素敏感性、抗糖尿病及抗炎症等作用，在糖尿病等代谢性疾病的发生发展过程中发挥重要的作用[2]。有报道表明，妊娠期糖尿病孕妇血清脂联素水平与正常健康孕妇比较明显降低[3]。本研究回顾性分析2013年3～12月在我院足月分娩的GDM孕妇、NGT孕妇共91例，比较两组研究对象胎儿脐血APN、新生儿体重、脐血糖化血红蛋白（HbA1C）及脐血胰岛素抵抗（IR），并进一步分析其与APN关系，现报道如下。

1 资料与方法

1.1 一般资料

回顾性分析2013年3～12月在我院住院足月分娩的孕妇91例，且均为单胎妊娠，年龄（26.28±4.96）岁，体重（64.73±9.18）kg，体重增加（16.89±3.01）kg，身高（160.23±26.72）cm，孕周（37.61±6.39）周，孕次（1.34±0.25）次。所有患者均进行OGTT试验，根据试验结果分为两组，GDM组61例，该组研究对象试验结果中三项血糖中均有一项血糖值表现异常；……