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目的:通过测定妊娠期糖尿病(GDM)脐血脂联素、胰岛素、C肽、糖化血红蛋白水平,探讨GDM对胎儿代谢水平的影响。方法:采用放射免疫法测定30例GDM患者及26例正常孕妇脐血脂联素、胰岛素、C肽水平,采用乳胶增强的免疫竞争抑制法测定脐血糖化血红蛋白水平。结果:GDM组脐血脂联素水平为(20.74±5.66)μg/ml,明显低于对照组(26.66±8.43)μg/ml,脐血胰岛素、糖化血红蛋白水平分别为(31.53±14.63)uIU/ml,(4.9±0.7)%,明显高于对照组,差异有统计学意义。两组脐血脂联素水平与脐血胰岛素、糖化血红蛋白呈明显负相关。结论:宫内暴露于GDM不良环境因素下可引起胎儿脂联素水平的下降及胰岛素、C肽、糖化血红蛋白水平的升高。胎儿代谢水平的改变影响了胎儿的生长发育,还可能与将来子代的代谢性疾病具有相关性。
OBJECTIVE: To investigate the effect of GDM on fetal metabolism by measuring cord blood adiponectin, insulin, C-peptide and glycated hemoglobin in gestational diabetes mellitus (GDM). Methods: Cord blood adiponectin, insulin and C-peptide levels were measured in 30 patients with GDM and 26 normal pregnant women by radioimmunoassay. The level of HbA1c was determined by latex-enhanced immunosuppression. Results: The level of cord blood adiponectin in GDM group was (20.74 ± 5.66) μg / ml, which was significantly lower than that in control group (26.66 ± 8.43) μg / ml. The levels of umbilical blood insulin and glycosylated hemoglobin were (31.53 ± 14.63) uIU / ml , (4.9 ± 0.7)%, respectively, which was significantly higher than that of the control group. The difference was statistically significant. Cord blood adiponectin levels and cord blood insulin, glycosylated hemoglobin was significantly negatively correlated. CONCLUSION: Intrauterine exposure to adverse environmental conditions of GDM can cause a decrease in fetal adiponectin levels and an increase in insulin, C-peptide, and HbA1c levels. Changes in fetal metabolism affect the fetal growth and development may also be related to future generations of metabolic diseases.