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目的:探讨血清瘦素与妊娠期糖尿病(GDM)的关系,了解瘦素、胰岛素及血脂水平在GDM中监测的意义。方法:采用放射免疫法测定GDM孕妇、糖耐量受损(IGT)孕妇、正常妊娠者、未妊娠妇女血清及新生儿脐血瘦素、胰岛素、C肽水平;同时测定各组妇女的血脂水平。结果:①GDM组瘦素水平高于IGT组、正常妊娠组及非妊娠组(P<0.01);各妊娠组的胰岛素水平差异无统计学意义(P>0.05);3组孕妇新生儿脐血瘦素水平比较,GDM组新生儿脐血瘦素低于IGT组及正常妊娠组(P<0.01)。②GDM、IGT孕妇血清瘦素与新生儿脐血瘦素无相关性(P>0.05)。③GDM孕妇血清瘦素与新生儿出生体重、宫内窘迫率有相关性,(P<0.01、P<0.05)。④各组孕妇产前血脂水平差异无统计学意义(P>0.05)。结论:①GDM孕妇血清瘦素增加,参与了GDM的发病过程,间接的影响了新生儿的出生体重。②孕妇血脂水平不能直接反映胎儿宫内生长发育状况。③瘦素可作为GDM孕妇预测胎盘缺氧、临床动态观察的围产期监护指标。
Objective: To investigate the relationship between serum leptin and gestational diabetes mellitus (GDM), and to understand the significance of monitoring leptin, insulin and lipid levels in GDM. Methods: The levels of serum leptin, insulin and C-peptide in serum of pregnant women with GDM, impaired glucose tolerance (IGT), normal pregnancy and non-pregnant women and neonates were measured by radioimmunoassay. Results: (1) The level of leptin in GDM group was higher than that in IGT group, normal pregnancy group and non-pregnant group (P <0.01). There was no significant difference in insulin level among the three pregnancy groups (P> 0.05) Compared with the IGT group and the normal pregnancy group, cord blood leptin of neonates in GDM group was significantly lower than that in normal pregnancy group (P <0.01). ②GDM, IGT pregnant women with serum leptin and cord blood leptin no correlation (P> 0.05). (3) Serum leptin level in GDM pregnant women was positively correlated with birth weight and intrauterine distress rate (P <0.01, P <0.05). ④ There was no significant difference in prenatal lipid levels between pregnant women in each group (P> 0.05). Conclusion: ① GDM pregnant women serum leptin increased, involved in the pathogenesis of GDM, indirectly affect the newborn’s birth weight. ② blood lipid levels in pregnant women can not directly reflect the growth and development of the fetus. ③ leptin as GDM pregnant women predict hypoxia, clinical observation of perinatal monitoring indicators.