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目的探讨妊娠期糖尿病(GDM)患者血清内脂素(visfatin)的变化及其与年龄、孕周、体质量指数(BMI)、血糖、胰岛素抵抗(HOMA-IR)、胰岛B细胞功能(HOMA-B)、血脂等的关系。方法 2009年7月至2009年12月在重庆医科大学附属第一医院门诊常规产前检查就诊者80名,按ADA2009年GDM诊断标准分为GDM组35例和非GDM组45例,ELISA法测定空腹血清visfatin水平,葡萄糖氧化酶法分别测定空腹血糖(FPG)及口服75g葡萄糖后0.5、1、2h血糖(0.5hPG、1hPG、2hPG),电化学发光法测定空腹胰岛素(FINS),酶法测定血脂等。结果①GDM患者空腹血清visfatin明显高于非GDM组(P<0.05);②Spearman相关分析显示,visfatin与2hPG(r=0.506、P<0.01)、FINS(r=0.321、P<0.01)、HOMA-IR(r=0.364、P<0.01)呈显著正相关;③多元线性逐步回归分析表明,2hPG是影响血清visfatin的独立相关因素。结论 GDM患者血清visfatin显著升高,可能是机体针对体内血糖增高、胰岛素抵抗所发生的一种代偿效应。
Objective To investigate the changes of serum visfatin and its relationship with age, gestational age, body mass index (BMI), blood glucose, insulin resistance (HOMA-IR), HOMA- B), blood lipids and other relations. Methods From July 2009 to December 2009, 80 outpatients were enrolled in the routine prenatal examination at the First Affiliated Hospital of Chongqing Medical University. According to the ADA 2009 GDM diagnostic criteria, 35 patients were divided into GDM group and 45 non-GDM patients. ELISA assay Fasting serum visfatin and glucose oxidase were used to measure fasting blood glucose (FPG) and blood glucose (0.5hPG, 1hPG, 2hPG) at 0.5h, 2h and 2h respectively after oral glucose administration. Electro-chemiluminescence was used to determine fasting insulin (FINS) Lipids and so on. Results ① The fasting serum visfatin in GDM patients was significantly higher than that in non-GDM patients (P <0.05). ②Spearman correlation analysis showed that visfatin was positively correlated with 2hPG (r = 0.506, P <0.01) (r = 0.364, P <0.01). ③multivariate linear stepwise regression analysis showed that 2hPG was an independent factor affecting serum visfatin. Conclusion Serum visfatin in GDM patients is significantly increased, which may be a compensatory effect of the body against the increase of blood glucose and insulin resistance in the body.