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目的：探讨血清脂联素水平对妊娠期糖尿病（GDM）患者远期心血管疾病（CVD）危险的预测作用。方法收集119例妊娠晚期（36～42周）孕妇作为研究对象，先按是否有 GDM分组，再按心血管危险因素（CVRF）个数分组，分为 GDM高危组（n ＝15）、GDM低危组（n ＝37）、正常糖耐量（NGT）高危组（n ＝18）、NGT 低危组（n ＝49），比较4组孕妇的一般情况、血压、血糖、血脂、胰岛素、血清脂联素水平，分析脂联素与 CVD 危险因素及其个数之间的相关性。结果4组孕妇的孕前体质量、孕前 BMI、产前 BMI、孕期增重、空腹血糖、1 h 餐后血糖、2 h 餐后血糖、收缩压、舒张压比较差异有统计学意义（P ＜0.05），年龄、产次、身高、产前体质量、胰岛素、总胆固醇、甘油三酯、HDL、LDL、ALT、AST、血清脂联素比较差异均无统计学意义（P 均＞0.05）。NGT低危组孕妇母体血清脂联素与空腹血糖、甘油三酯呈负相关（r 分别为－0.369、－0.343，P 均＜0.05），NGT 高危组母体血清脂联素与胰岛素呈正相关（r ＝0.495，P ＜0.05），GDM低危组母体血清脂联素与 HDL 呈正相关（r ＝0.404，P ＜0.05），GDM高危组母体血清脂联素与空腹血糖呈负相关（r ＝－0.516，P ＜0.05）。血清脂联素与 CVD 危险负荷个数无关（P ＞0.05）。结论妊娠晚期脂联素改变可能发生在糖代谢紊乱之前，可能影响 GDM孕妇远期 CVD 发病危险，但脂联素尚不能作为远期 CVD 危险的特异性预测因素。“,”Objective To evaluate the predictive value of serum adiponectin (APN)on the long-term risk of cardiovascular disease (CVD)in patients with gestational diabetes mellitus (GDM).Methods A total of 119 women in late pregnancy (36 ~42 weeks)were recruited as study subjects.According to GDMand number of cardiovascular risk factor load (CVRF),119 participants were divided into the high-risk CVRF with GDM(n =15),low-risk CVRF with GDM(n =37),high-risk GDMwith normal glucose tolerance (NGT)(n=18)and low-risk CVRF with NGT groups (n =49).General condition,blood pressure,blood glucose, blood lipid,insulin and serum APN were statistically compared among four groups.The correlation between APN and CVRF and its quantity was analyzed.Results Pregestational body weight,pregestational and prepar-tum body mass index (BMI),weight gain during pregnancy,fasting blood glucose,1-h and 2-h postprandial blood glucose,systolic and diastolic blood pressure all significantly differed among four groups(all P 0.05).In the low-risk CVRF with NGT group,serum APN was negatively correlated with fasting blood glucose and triglyceride (r =-0.369 and -0.343,both P <0.05).In the high-risk CVRF with NGT group,serum APN was positively correlated with insulin (r =495,P <0.05).Serum APN was positively associated with HDL in the low-risk CVRF withGDMgroup (r =0.404,P <0.05).In the high-risk CVRF with GDMgroup,serum APN was negatively cor-related with fasting blood glucose (r =-0.516,P 0.05).Conclusions Changes in the serum APN level during late pregnancy probably occurred prior to the disturbance of carbohydrate metabolism and potentially affected the long-term risk of CVD in GDM women.Increasing serum APN level may be a potential method to prevent the long-term risk of CVD.Howev-er,it still cannot serve as a specific predictive factor for the long-term CVD.