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目的探讨瘦素、脂联素与妊娠期糖尿病胰岛素抵抗的关系。方法采用稳态模型评估法评估正常糖耐量孕妇(NGT)糖耐量减低孕妇(GIGT)和妊娠期糖尿病孕妇(GDM)的胰岛素抵抗指数,采用放射免疫分析方法检测其血浆瘦素、脂联素、血糖及胰岛素水平。结果 GDM组和GIGT组HOMA-IR显著高于NGT组,GDM组HOMA-IR显著高于GIGT组。血清瘦素水平由NGT组到GIGT组和GDM组呈显著增高,瘦素与空腹胰岛素、孕晚期体重指数、HOMA-IR呈显著正相关;血清脂联素由NGT组到GIGT组和GDM组呈显著下降,脂联素与空腹胰岛素、孕晚期体重指数、HOMA-IR呈显著负相关。结论瘦素、脂联素水平与GDM患者IR程度密切相关,其水平可作为预测妊娠期糖尿病胰岛素敏感性的指标,将来可能是治疗妊娠期糖尿病的新靶点。
Objective To investigate the relationship between leptin, adiponectin and gestational diabetes mellitus insulin resistance. Methods The insulin resistance index of normal glucose tolerance pregnant women (NGT) with impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM) was assessed by the steady state model assessment. Plasma leptin, adiponectin, Blood glucose and insulin levels. Results The HOMA-IR in GDM group and GIGT group was significantly higher than that in NGT group. The HOMA-IR in GDM group was significantly higher than that in GIGT group. Serum leptin level increased significantly from NGT group to GIGT group and GDM group, and leptin was positively correlated with fasting insulin, third trimester pregnancy body mass index and HOMA-IR. Serum adiponectin was significantly increased in NGT group to GIGT group and GDM group Significantly decreased, adiponectin and fasting insulin, third trimester pregnancy body mass index, HOMA-IR was significantly negatively correlated. Conclusion The levels of leptin and adiponectin are closely related to the IR of GDM patients. The levels of leptin and adiponectin may be used as predictors of insulin sensitivity in gestational diabetes mellitus, and may be a new target for the treatment of gestational diabetes mellitus in the future.