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目的探讨妊娠合并糖尿病(GDM)患者血清Nesfatin-1和视黄醇结合蛋白-4(RBP-4)水平检测的临床意义。方法将50例确诊为GDM的妊娠中期妇女作为观察组,同期选取50例无糖尿病、正常妊娠中期妇女作为对照组。对比分析2组血清Nesfatin-1、RBP-4、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(Hb A1c)、血脂(TC、TG、LDL-C、HDL-C)水平,以及胰岛素抵抗指数(HOMA-IR)差异。结果观察组孕妇的FPG、FINS、Hb A1c水平、HOMA-IR、TC、TG及LDL-C水平均高于对照组,而HDL-C水平低于对照组,差异均有统计学意义(P<0.05)。观察组孕妇血清Nesfatin-1和RBP-4水平均高于对照组,差异有统计学意义(P<0.01)。Nesfatin-1分别与FPG、FINS、Hb A1c、HOMA-IR及TG呈显著正相关(P<0.05);RBP-4分别与FINS、Hb A1c、HOMA-IR及TG呈显著正相关(P<0.05)。结论 GDM孕妇血清Nesfatin-1和RBP-4水平升高,并与GDM糖脂代谢紊乱密切相关,二者联合检测对GDM的临床诊断具有重要参考价值。
Objective To investigate the clinical significance of the serum levels of Nesfatin-1 and retinol binding protein-4 (RBP-4) in patients with gestational diabetes mellitus (GDM). Methods 50 pregnant women diagnosed as GDM were selected as the observation group. Fifty women without diabetes and normal pregnancy in the same period were selected as the control group. The levels of serum Nesfatin-1, RBP-4, fasting blood glucose (FPG), fasting insulin (FINS), Hb A1c and blood lipid (TC, TG, LDL-C and HDL-C) Resistance index (HOMA-IR) differences. Results The levels of FPG, FINS, Hb A1c, HOMA-IR, TC, TG and LDL-C in pregnant women in observation group were higher than those in control group, while the levels of HDL-C in pregnant women were lower than those in control group (P < 0.05). The levels of serum Nesfatin-1 and RBP-4 in the observation group were higher than those in the control group, with significant difference (P <0.01). There was a significant positive correlation between Nesfatin-1 and FPG, FINS, HbA1c, HOMA-IR and TG (P <0.05); RBP-4 was positively correlated with FINS, ). Conclusion The levels of serum Nesfatin-1 and RBP-4 in pregnant women with GDM are elevated, which are closely related to the disorder of glucose and lipid metabolism in GDM. The combined detection of them has important reference value for the clinical diagnosis of GDM.