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目的:探究糖化白蛋白及脂联素在妊娠糖尿病早期筛查中的作用。方法:从2012年4月至2014年2月来瑞安市人民医院进行常规查体的妊娠妇女中,依据糖尿病检测标准选取糖耐量正常患者60例作为A组,糖耐量减低患者60例作为B组,妊娠期糖尿病患者80例作为C组。对C组患者进行有效的个体化治疗,并于4周后依据治疗效果将C组分为C1组(血糖控制良好组)及C2组(血糖控制不佳组),其中C1组48例,C2组32例。分别于本次查体及4周后查体时检测各组的空腹血糖(FBG)、餐后两小时血糖(2hPBG)、空腹胰岛素水平(FINS)、糖化白蛋白(GA)、糖化血红蛋白(HbA1c)、脂联素(APN)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)。结果:C组患者的FBG、2hPBG、FINS、GA、HbA1c、TC、TG及LDL-C均明显高于A组及B组,C组患者的APN及HDL-C明显低于A组及B组,差异有统计学意义(P<0.05);C1组患者的FBG、2hPBG、FINS及GA明显低于C2组(P<0.05);C1组患者的HbA1c与C2组比较虽有所下降,但差异无统计学意义(P>0.05);通过多因素相关性分析,患者的GA水平与FBG、FINS及HbA1c呈明显正相关(r=0.385,0.856,0.835,P<0.05);患者的APN值与FBG、FINS、HbA1c及TG呈明显负相关(r=-0.495,-0.964,-0.352,-0.294,P<0.05)。结论:GA及APN检测可明显提高孕期糖尿病患者的早期筛查准确率,且GA在对血糖趋势的变化检测上稳定性优于FBG,灵敏度优于HbA1c。
Objective: To investigate the role of glycated albumin and adiponectin in the early screening of gestational diabetes mellitus. Methods: From April 2012 to February 2014 in Ruian City People’s Hospital for routine physical examination of pregnant women, according to the standard of diabetes test selected 60 patients with normal glucose tolerance as a group, 60 patients with impaired glucose tolerance as a group B , 80 cases of gestational diabetes as C group. The patients in group C were effectively treated individually. After 4 weeks, patients in group C were divided into group C1 (good blood glucose control group) and C2 group (poor blood glucose control group), of which 48 patients in group C1, C2 Group of 32 cases. Fasting blood glucose (FBG), two hours postprandial blood glucose (2hPBG), fasting insulin (FINS), glycosylated albumin (GA), glycosylated hemoglobin (HbA1c , APN, TC, TG, LDL-C and HDL-C were measured. Results: The levels of FBG, 2hPBG, FINS, GA, HbA1c, TC, TG and LDL-C in group C were significantly higher than those in group A and group B. The APN and HDL-C in group C were significantly lower than those in group A and B (P <0.05). The FBG, 2hPBG, FINS and GA in C1 group were significantly lower than those in C2 group (P <0.05). The difference between HbA1c group and C2 group in C1 group was statistically significant There was a significant positive correlation between GA level and FBG, FINS and HbA1c (r = 0.385, 0.856, 0.835, P <0.05) by multivariate analysis; FBG, FINS, HbA1c and TG were negatively correlated (r = -0.495, -0.964, -0.352, -0.294, P <0.05). Conclusion: The detection of GA and APN can significantly improve the early screening accuracy of diabetics during pregnancy, and GA is superior to FBG in the detection of changes in blood glucose trend and its sensitivity is better than that of HbA1c.