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目的:研究孕早中期血清抵抗素、脂联素及铁蛋白水平与妊娠期糖尿病的相关性。方法:选取孕早期(11-13周)、孕中期(24-28周)诊断为GDM的孕妇46例作为试验组(GDM组),及同期糖代谢正常的孕妇46例作为对照组(NGT组),检测和比较两组孕早、中期血清脂联素、抵抗素、铁蛋白水平,计算各期胰岛素稳态模型抵抗指数(HOMA-IR),并对孕早中期血清抵抗素、脂联素及铁蛋白(SF)水平与HOMA-IR进行相关性分析。结果:与NGT组比较,GDM组孕早、中期血清脂联素水平均显著降低,且孕早期血清脂联素水平与HOMR-IR呈负相关(r=-0.21,P<0.05);孕早、中期血清SF水平均显著升高,且孕早期血清SF水平与IR呈正相关(r=0.238,P<0.05);孕早期血清抵抗素水平无明显变化(P>0.05),但孕中期血清抵抗素水平显著降低(P<0.05)。多元线性回归分析结果显示孕早期血清铁蛋白水平对HOMA-IR的影响更显著,孕早期SF每升高1μg/l,HOMA-IR提高0.179。孕早期SF水平作为预测GDM发病的血清学阈值为≥23.2μg/L。结论:孕早期血清脂联素及SF水平变化均与GDM的发病相关,孕早期血清SF水平可能作为早期诊断和预防GDM的血清学指标。
Objective: To study the correlation between serum resistin, adiponectin and ferritin levels and gestational diabetes mellitus in early pregnancy. Methods: 46 pregnant women diagnosed as GDM during the first trimester (11-13 weeks) and the second trimester (24-28 weeks) were selected as the experimental group (GDM group) and 46 pregnant women with normal glucose metabolism during the same period as the control group (NGT group ), Serum levels of adiponectin, resistin and ferritin were detected and compared in early and middle stages of pregnancy. HOMA-IR was calculated and the levels of serum resistin, adiponectin And ferritin (SF) levels with HOMA-IR correlation analysis. Results: Compared with NGT group, the level of serum adiponectin was significantly lower in the early and middle stages of GDM group, and the serum adiponectin level was negatively correlated with HOMR-IR (r = -0.21, P <0.05) in early pregnancy; (P <0.05). There was no significant difference in serum resistin levels in the first trimester (P> 0.05), but in the second trimester serum level of serum resistance The level of insulin decreased significantly (P <0.05). Multivariate linear regression analysis showed that serum ferritin levels in early pregnancy had a more significant effect on HOMA-IR, with HIF-IR increased by 0.179 for every 1 μg / l of SF in early pregnancy. The serum level of SF in early pregnancy as the predictor of GDM was ≥23.2 μg / L. Conclusion: Serum levels of adiponectin and SF in the first trimester of pregnancy are both correlated with the pathogenesis of GDM. Serum SF level in early trimester may serve as a serological marker for early diagnosis and prevention of GDM.