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目的探讨妊娠期糖尿病(GDM)患者血清中Nesfatin-1水平及糖脂代谢紊乱的相关性。方法 2013年1月至2014年1月妊娠中期(24-28w)诊断GDM的68例孕妇为GDM组,选取同期正常妊娠中期孕妇136例作为对照组。采用使用酶联免疫吸附法(ELISA)检测血清Nesfatin-1水平,检测总胆固醇(TC)、甘油三脂(TG)、载脂蛋白A(apo A)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、载脂蛋白A(apo A)、空腹血糖(FPG)、餐后1h血糖(1h PG)、餐后2h血糖(2h PG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR),比较两组的差异、分析血清Nesfatin-1与胰岛素抵抗相关性。结果 GDM组血清Nesfatin-1(0.98±0.54)(μg/L)、HDL-C(1.25±0.47)(mmol/L)明显低于对照组(1.54±0.38,P<0.01;1.36±0.29,P<0.05)。GDM组血清TG(2.91±0.93)(mmol/L)、LDL-C(2.93±0.76)(mmol/L)、apo A(1.54±0.21)(g/L)、FPG(5.32±0.62)(mmol/L)、2h PG(8.67±1.04)(mmol/L)、FINS(16.98±1.04)(m U/L)和HOMA-IR(4.52±0.64)均明显高于对照组[TG(2.59±0.61,P<0.05)(mmol/L)、LDL-C(2.68±0.59,P<0.01)(mmol/L)、apo A(0.86±0.37,P<0.01)(g/L)、FPG(4.35±0.41,P<0.01)(mmol/L)、2h PG(6.29±0.88,P<0.01)(mmol/L)、FINS(13.11±2.36,P<0.01)(m U/L)和HOMA-IR(2.47±0.28,P<0.01)]。相关性分析显示,GDM孕妇血清Nesfatin-1与TG、LDL、HDL、FPG、2h PG、FINS及HOMA-IR呈负相关(r=-0.557,P<0.01;r=-0.57,P<0.01;r=-0.63,P<0.01;r=-0.60,P<0.01;r=-0.71,P<0.01;r=-0.71,P<0.01;r=-0.68,P<0.01)。结论 GDM孕妇血清Nesfatin-1水平降低;Nesfatin-1降低与GDM糖脂代谢紊乱密切相关。
Objective To investigate the correlation between serum levels of Nesfatin-1 and dyslipidemia in patients with gestational diabetes mellitus (GDM). Methods From January 2013 to January 2014, 68 pregnant women with GDM during the second trimester of pregnancy (24-28w) were selected as the GDM group. 136 pregnant women of the same period of normal pregnancy were selected as the control group. Serum levels of Nesfatin-1 were detected by enzyme-linked immunosorbent assay (ELISA). Total cholesterol (TC), triglyceride (TG), apolipoprotein A, LDL- HDL-C, apo A, fasting blood glucose (FPG), 1h postprandial blood glucose (1h PG), 2h postprandial blood glucose (2h PG) and fasting insulin (FINS) The insulin resistance index (HOMA-IR) was calculated and compared between the two groups. The correlation between serum Nesfatin-1 and insulin resistance was analyzed. Results Serum levels of Nesfatin-1 (0.98 ± 0.54) and HDL-C (1.25 ± 0.47) mmol / L in GDM group were significantly lower than those in control group (1.54 ± 0.38, P <0.01, 1.36 ± 0.29, P <0.05). The serum levels of TG in serum of GDM group were 2.91 ± 0.93 mmol / L, 2.93 ± 0.76 mmol / L, 1.54 ± 0.21 g / L and 5.32 ± 0.62 FPG, respectively (P <0.05). The levels of FINS (mU / L) and HOMA-IR (4.52 ± 0.64) in 2h PG were significantly higher than those in control group [TG (2.59 ± 0.61 (P <0.05), LDL-C (2.68 ± 0.59, P <0.01), apo A (0.86 ± 0.37, P <0.01) 0.21, P <0.01), 2h PG (6.29 ± 0.88, P <0.01), FINS (13.11 ± 2.36, P <0.01) 2.47 ± 0.28, P <0.01)]. Correlation analysis showed that serum Nesfatin-1 in GDM pregnant women was negatively correlated with TG, LDL, HDL, FPG, 2h PG, FINS and HOMA-IR (r = -0.557, P <0.01; r = -0.63, P <0.01; r = -0.60, P <0.01; r = -0.71, P <0.01; r = -0.71, P <0.01; r = -0.68, P <0.01). Conclusion The level of serum Nesfatin-1 in GDM pregnant women is decreased. The decrease of Nesfatin-1 is closely related to the disorder of glucose and lipid metabolism in GDM.