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目的探究妊娠期糖尿病(GDM)患者血清视黄醇结合蛋白4(RBP4)和铁蛋白(SF)的表达及与胰岛素抵抗(IR)的关系。方法选择2014年12月-2016年3月入医院进行葡萄糖筛查的70例孕产妇纳入本研究,其中37例妊娠糖尿病患者为A组,33例妊娠正常糖耐量者为B组,同时选择30例正常健康非妊娠妇女为C组,对比各组年龄、孕前体质量指数(BMI)、孕期BMI、孕周、空腹血糖(FPG)、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(HDL-C)、糖化血红蛋白(Hb A1c)、血清RBP4、空腹胰岛素(FINS)、血清SF、IR指数(HOMA-IR)。结果 3组孕前BMI差异有统计学意义(P<0.05);A组孕期BMI、孕期体质量增加均明显大于B组,差异有统计学意义(P<0.05)。3组FBS、FINS、HOMA-IR、Hb A1c、TG、RBP4、SF、HDL-C比较差异有统计学意义(P<0.05),且A组的FBS、FINS、HOMAIR、Hb A1c、TG、RBP4、SF明显高于B组和C组,而HDL-C明显低于B组和C组,差异均有统计学意义(P<0.05)。GDM患者血清RBP4的水平与孕期BMI、孕期体质量增加、FBS、FINS、HOMA-IR、TG、Hb A1c呈正相关(P<0.05),GDM组血清SF与孕期体质量增加、FBS、FINS、HOMA-IR、TG、Hb A1c呈现正相关(P<0.05)。结论 GDM患者血清RBP4和SF明显高于正常糖耐量孕妇及非妊娠健康妇女且均与IR相关,血清RBP4和SF可能通过调节IR而参与GDM的发生和发展。
Objective To investigate the relationship between serum retinol binding protein 4 (RBP4) and ferritin (SF) and insulin resistance (IR) in patients with gestational diabetes mellitus (GDM). Methods Seventy pregnant women who entered the hospital for glucose screening from December 2014 to March 2016 were enrolled in this study. Among 37 pregnant women with gestational diabetes mellitus, 37 were pregnant women with gestational diabetes mellitus, 33 with gestational normal glucose tolerance were in group B, and 30 The normal healthy non-pregnant women were divided into group C and compared with age, body mass index (BMI), pregnancy BMI, gestational age, fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG) LDL-C, HDL-C, Hb A1c, serum RBP4, fasting insulin (FINS), serum SF and IR index (HOMA-IR). Results There were significant differences in BMI before pregnancy between the three groups (P <0.05). The BMI during pregnancy and the weight gain during pregnancy were significantly higher in group A than in group B (P <0.05). There were significant differences in FBS, FINS, HOMA-IR, HbA1c, TG, RBP4, SF and HDL-C between the three groups (P <0.05) , SF was significantly higher than those in group B and C, while HDL-C was significantly lower than those in group B and C (P <0.05). Serum levels of RBP4 in GDM patients were positively correlated with BMI during pregnancy, body mass gain during pregnancy, FBS, FINS, HOMA-IR, TG and Hb A1c (P <0.05) -IR, TG, Hb A1c showed a positive correlation (P <0.05). Conclusion Serum RBP4 and SF levels in patients with GDM are significantly higher than those in normal glucose tolerance pregnant women and non-pregnant women and are related to IR. Serum RBP4 and SF may participate in the occurrence and development of GDM through the regulation of IR.