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目的探讨妊娠期糖尿病(GDM)患者血清及脐血内脏脂肪素(Visfatin)含量检测及其与母体糖脂代谢和胎儿宫内发育的相关性。方法选取2012年5月-2015年10月小榄医院收治的76例GDM患者为观察组,另取同期进行产检的70例血糖正常孕妇为对照组。根据血清及脐血Visfatin水平中位数,进一步将观察组分为血清高Visfatin组40例、低Visfatin组36例,脐血高Visfatin组42例和低Visfatin组34例。采用酶联免疫吸附法(ELISA)检测各组孕妇的血清及脐血Visfatin水平;检测外周血糖脂代谢指标水平,包括空腹血糖(FPG)、糖化血红蛋白(HbA 1c)、空腹胰岛素(FINS)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、载脂蛋白A1(ApoA 1);记录两组新生儿的出生体质量和出生体质量指数(Ponderal index,PI)。结果观察组血清及脐血Visfatin水平高于对照组(P<0.05);血清及脐血高Visfatin组FPG、HbA 1c、FINS水平高于低Visfatin组,TG水平高于低Visfatin组,HDL-c、ApoA 1水平低于低Visfatin组(P<0.05);血清及脐血高Visfatin组新生儿出生体质量及PI值高于低Visfatin组(P<0.05)。结论 GDM患者血清及脐血存在Visfatin高表达,且Visfatin水平与母体糖脂代谢和胎儿宫内发育存在直接相关关系。
Objective To investigate the detection of visfatin in serum and umbilical cord blood of patients with gestational diabetes mellitus (GDM) and its relationship with maternal glucose and lipid metabolism and fetal intrauterine growth. Methods Seventy-six patients with GDM treated in Siu Lam Hospital from May 2012 to October 2015 were selected as the observation group. Another 70 pregnant women with normal glucose level were enrolled as the control group. According to the median of serum and umbilical cord blood Visfatin levels, the observation group was further divided into the serum Visfatin group 40 cases, low Visfatin group 36 cases, umbilical cord blood Visfatin group 42 cases and low Visfatin group 34 cases. Serum and umbilical cord blood Visfatin levels were measured by enzyme-linked immunosorbent assay (ELISA). The levels of peripheral blood glucose and lipid metabolism indexes, including fasting blood glucose (FPG), HbA 1c, FINS, Triglyceride (TG), high density lipoprotein cholesterol (HDL-c) and apolipoprotein A1 (ApoA 1). The birth weight and Ponderal index (P) of the newborns were recorded. Results The level of Visfatin in serum and umbilical cord blood of the observation group was higher than that of the control group (P <0.05). The levels of FPG, HbA 1c and FINS in serum and umbilical cord blood Visfatin group were higher than those in the low Visfatin group, TG level was higher than that in the low Visfatin group, HDL-c (P <0.05). The birth weight and PI of newborns in serum and umbilical cord blood Visfatin group were higher than those in low Visfatin group (P <0.05). Conclusion Visfatin is highly expressed in serum and umbilical cord blood of patients with GDM, and the level of Visfatin is directly related to the metabolism of maternal glycolipids and intrauterine growth.