摘要
目的:探讨早孕期妇女血清补体C1q-肿瘤坏死因子相关蛋白3(CTRP3)与胰岛素抵抗的关系,为妊娠期糖尿病(GDM)发病机制及预测研究提供新的思路。方法:收集6~14周妊娠妇女的年龄、孕龄、孕前体重等信息,检测其空腹血糖(FPG)、血脂、糖化血红蛋白、空腹胰岛素(FINS)等指标,酶联免疫吸附试验检测血清CTRP3水平。妊娠24~28周行75g口服葡萄糖耐量试验,分析早孕期妇女血清CTRP3水平与胰岛素抵抗的关系。结果:共纳入早孕期妇女374例,完成随访357例,其中79例诊断为GDM,278例糖耐量正常(NGT),GDM发病率为22.13%。与NGT组相比,GDM组孕妇的年龄、孕前体重指数(BMI)、基线BMI、FPG、FINS、糖化血红蛋白、甘油三酯、胰岛素抵抗指数(HOMA-IR)均升高,差异有统计学意义(P<0.05)。两组的基线孕龄、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及胰岛β细胞功能指数差异均无统计学意义(P>0.05)。GDM组的血清CTRP3水平低于NGT组[0.524(0.461~0.636)ng/ml vs 0.606(0.511~0.667)ng/ml],差异有统计学意义(P<0.01)。相关分析显示,HOMA-IR与孕前BMI呈正相关,与血清CTRP3水平呈负相关(P<0.05)。校正年龄、孕前BMI等因素后,线性回归分析结果显示CTRP3是HOMA-IR的独立影响因素。结论:GDM孕妇血清CTRP3水平在早孕期已开始降低,并通过增加胰岛素抵抗水平而促进GDM的发生。
Objective:To investigate the relationship between serum complement C1 q-tumor necrosis factor-related protein 3(CTRP3)and insulin resistance in early pregnancy,and to provide new ideas for the pathogenesis and prediction of gestational diabetes mellitus(GDM).Methods:The informations of age,gestational age and pre-pregnancy weight of pregnant women from 6 to 14 weeks were collected.Their fasting plasma glucose(FPG),blood lipid,glycosylated hemoglobin,fasting insulin(FINS)and other indicators were detected,the level of serum CTRP3 by ELISA was detect.The 75 g oral glucose tolerance test was performed at 24~28 weeks of pregnancy to analyze the relationship between serum CTRP3 levels and insulin resistance in early pregnancy.Results:A total of 374 women were enrolled in the early pregnancy,and 357 patients were followed up.Of these,79 cases were diagnosed as GDM and 278 cases were normal glucose tolerance(NGT).The incidence of GDM was 22.13%.Compared with NGT group,the age,body mass index(BMI),baseline BMI,FPG,FINS,glycosylated hemoglobin,triglyceride and homeostasis model assessment of insulin resistance index(HOMA-IR)of pregnant women in GDM group increased significantly(P<0.05).There was no significant difference in baseline gestational age,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol and homeostasis model formula for calculating isletβcell function index(P>0.05).Serum CTRP3 level in GDM group was lower than that in NGT group[0.524(0.461~0.636)ng/ml vs 0.606(0.511~0.667)ng/ml],with statistical difference.The correlation analysis showed that HOMA-IR was positively correlated with pre-pregnancy BMI and negatively correlated with serum CTRP3 level(P<0.05).After adjusting for age and pre-pregnancy BMI,linear regression analysis showed that CTRP3 was an independent influencing factor of HOMA-IR.Conclusion:The serum CTRP3 level of GDM pregnant women has begun to decrease in early pregnancy,and it can promote the occurrence of GDM by increasing insulin resistance.
作者
张丽倩
郭艳巍
许倩
毛淑芳
Zhang Liqian;Guo Yanwei;Xu Qian(Department of Preventive Medicine,Chengde Medical University,Chengde 067000;Department of Obstetrics,Affiliated Hospital of Chengde Medical University,Chengde 067000;Institute of Basic Medicine,Chengde Medical University,Chengde 067000)
出处
《现代妇产科进展》
CSCD
北大核心
2020年第6期434-437,共4页
Progress in Obstetrics and Gynecology
基金
河北省医学科学研究重点课题计划(No:20170874)
河北省科技计划项目(No:162777102D)
河北省财政厅河北省卫生健康委2019年政府资助临床医学优秀人才培养项目补助计划。
