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目的探讨妊娠期糖尿病(GDM)患者血清人胎球蛋白A(AHSG)水平及胰岛素敏感性的相关性。方法选择妊娠中期(24~28周)诊断为GDM的孕妇79例纳入GDM组,选取同期正常妊娠中期孕妇131人作为对照组。采用酶联免疫吸附法(ELISA)检测血清AHSG水平和总胆固醇(TC)、甘油三酯(TG)和载脂蛋白A(apo A)等指标,计算胰岛素抵抗指数(HOMA-IR),分析血清AHSG与GDM患者胰岛素抵抗相关性。结果GDM组孕妇血清AHSG(249.30±17.50)μg/L、TG(2.85±0.57)mmol/L、LDL-C(2.88±0.31)mmol/L、apo A(1.29±0.32)g/L、CR(85.02±5.79)mmol/L、UA(402.90±25.47)μmol/L、FPG(5.54±0.86)mmol/L、1 h PG(9.00±1.15)mmol/L、FINS(16.13±0.56)m U/L和HOMA-IR(3.98±0.65)均明显高于对照组。HDL-C(1.21±0.11)mmol/L明显低于对照组(P<0.05)。GDM组血清相关性分析显示,GDM孕妇血清AHSG与TG、TC、LDL-C、HDL-C、apo A、ALT、AST、ALP、GGT、CR、BUN、HS-CRP、FPG、1 h PG、2 h PG、FINS、HOMA-IR无明显相关性。结论妊娠中期GDM孕妇血清AHSG水平升高,与GDM胰岛素抵抗及糖脂代谢紊乱无明显相关性。
Objective To investigate the relationship between serum human fetuin A (AHSG) level and insulin sensitivity in patients with gestational diabetes mellitus (GDM). Methods Seventy-nine pregnant women who were diagnosed as GDM during the second trimester of pregnancy (24-28 weeks old) were enrolled in the GDM group. Totally 131 pregnant women of the same period of normal pregnancy were selected as the control group. Serum AHSG, total cholesterol (TC), triglyceride (TG) and apolipoprotein A (apo A) were measured by enzyme linked immunosorbent assay (ELISA), insulin resistance index (HOMA-IR) AHSG and insulin resistance in patients with GDM. Results Serum levels of AHSG (249.30 ± 17.50) μg / L, TG (2.85 ± 0.57) mmol / L and LDL-C (2.88 ± 0.31) mmol / L and apo A (1.29 ± 0.32) g / 85.02 ± 5.79 mmol / L, UA 402.90 ± 25.47 μmol / L, FPG 5.54 ± 0.86 mmol / L, PGI 9.00 ± 1.15 mmol / L and FINS 16.13 ± 0.56 μmol / And HOMA-IR (3.98 ± 0.65) were significantly higher than the control group. HDL-C (1.21 ± 0.11) mmol / L was significantly lower than that of the control group (P <0.05). GDM group serum correlation analysis showed that GHS pregnant women serum AHSG and TG, TC, LDL-C, HDL-C, apo A, ALT, AST, ALP, GGT, CR, BUN, HS-CRP, 2 h PG, FINS, HOMA-IR no significant correlation. Conclusion The level of AHSG in pregnant women with GDM in the second trimester of pregnancy is not significantly correlated with the insulin resistance and dyslipidemia of GDM.