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目的:研究正常孕妇和妊娠期糖尿病(GDM)孕妇母体及脐血中的同型半胱氨酸(Hcy)水平,探讨母体血清Hcy水平与GDM的关系。方法:选取2012年1月至2012年12月在我院常规产前检查的30例正常孕妇及30例GDM孕妇。ELISA法检测外周血及脐血Hcy水平,分析母体血Hcy水平与GDM孕妇相关临床特征的关系。结果:正常组和GDM组的母体血Hcy水平分别为(14.9±7.1)μmol/L和(15.2±6.2)μmol/L,无显著差异(P>0.05)。GDM组母体血Hcy水平与叶酸(FA)水平呈负相关(r=-0.375,P<0.05);与胰岛素抵抗、血脂及胎儿出生体重均无明显相关性。正常组和GDM组脐血Hcy水平分别为(13.3±5.2)μmol/L和(13.7±5.2)μmol/L,均显著低于母体血Hcy水平(P<0.05),且与母体血Hcy水平呈显著正相关(r=0.820,P<0.001;r=0.799,P<0.001)。结论:GDM孕妇经饮食运动治疗后孕晚期血Hcy无明显升高,且与胰岛素抵抗无明显相关。GDM脐血Hcy水平与正常孕妇相似,母体血Hcy水平可能是影响胎儿Hcy水平的主要因素。
Objective: To study the level of homocysteine (Hcy) in maternal and umbilical cord blood of pregnant women and gestational diabetes mellitus (GDM), and to explore the relationship between maternal serum Hcy level and GDM. Methods: From January 2012 to December 2012 in our hospital routine prenatal examination of 30 cases of normal pregnant women and 30 cases of GDM pregnant women. ELISA assay of peripheral blood and umbilical cord blood Hcy levels, maternal plasma homocysteine levels and GDM related clinical features of pregnant women. Results: There was no significant difference in maternal serum homocysteine (Hcy) level between the normal group and the GDM group (14.9 ± 7.1) μmol / L and (15.2 ± 6.2) μmol / L, respectively (P> 0.05). Hcy levels in maternal blood of GDM group were negatively correlated with folic acid (r = -0.375, P <0.05), but not with insulin resistance, blood lipids and birth weight. Hcy levels in umbilical cord blood were (13.3 ± 5.2) μmol / L and (13.7 ± 5.2) μmol / L in normal and GDM groups, respectively, which were significantly lower than those in maternal plasma (P <0.05) There was a significant positive correlation (r = 0.820, P <0.001; r = 0.799, P <0.001). Conclusion: The serum homocysteine levels in pregnant women with GDM after pregnancy were not significantly elevated, and had no significant correlation with insulin resistance. The Hcy level in cord blood of GDM is similar to that of normal pregnant women, and the level of Hcy in maternal blood may be the main factor affecting the level of Hcy in the fetus.