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目的通过对孕妇脂肪因子脂联素(APN)、内脂素、肿瘤坏死因子-α(TNF-α)、瘦素等指标进行监测,探讨APN、内脂素、TNF-α、瘦素与妊娠期糖尿病(GDM)的相关性。方法随机抽取2014年10月-2015年10月在该院门诊进行产前检查的24~28孕周孕妇88例,根据75 g口服葡萄糖耐量试验(OGTT)结果分为正常血糖(NGT)组(42例)和GDM组(46例)。分别对两组孕妇进行APN、内脂素、TNF-α、瘦素的监测,并进行记录。结果两组间年龄、孕龄例数比较,差异无统计学意义(P>0.05),GDM组与NGT组比较,年龄、体质量指数(BMI)差异无统计学意义(P>0.05),空腹血糖(FPG)、糖化血红蛋白A1c(GHb A1c)、空腹胰岛素(FINS)明显升高(P<0.05)。HOMA-IR、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)明显升高(P<0.05),胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)差异无统计学意义(P>0.05)。GDM组APN明显低于NGT组(P<0.05),内脂素、TNF-α、瘦素明显高于NGT组(P<0.05)。GDM组HOMA-IR与年龄、BMI、FPG、GHb A1c、FINS、TG、TC、LDL-C、内脂素、TNF-α、瘦素呈正相关(r分别为0.330、0.593、0.843、0.828、0.908、0.341、0.345、0.301、0.338、0.334、0.234,均P<0.05),与APN呈负相关(r=-0.612,P<0.05)。结论本研究为实施干预治疗、延缓病程进展、降低GDM的发生提供理论和实验依据,大大降低了不良妊娠结局的发生,将会创造更大的社会价值。
Objective To investigate the effects of APN, visfatin, TNF-α, leptin and pregnancy on the levels of adiponectin (APN), visfatin, tumor necrosis factor-α (TNF- Stage Diabetes Mellitus (GDM). Methods A total of 88 pregnant women of 24 to 28 gestational weeks in our outpatient department from October 2014 to October 2015 were randomly selected and divided into the group of normal glucose (NGT) according to the result of 75 g oral glucose tolerance test (OGTT) 42 cases) and GDM group (46 cases). The two groups of pregnant women APN, visfatin, TNF-α, leptin monitoring, and recorded. Results There was no significant difference in age and gestational age between the two groups (P> 0.05). There was no significant difference in age and body mass index (BMI) between GDM group and NGT group (P> 0.05) FPG, GHb A1c and FINS were significantly increased (P <0.05). HOMA-IR, triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were significantly increased (P <0.05), while there were no significant differences in cholesterol (TC) and high density lipoprotein cholesterol (P> 0.05). The APN in GDM group was significantly lower than that in NGT group (P <0.05). The contents of visfatin, TNF-α and leptin in NGT group were significantly higher than those in NGT group (P <0.05). HOMA-IR in GDM group was positively correlated with age, BMI, FPG, GHb A1c, FINS, TG, TC, LDL-C, visfatin, TNF- α and leptin (r = 0.330,0.593,0.843,0.828,0.908 , 0.341,0.345,0.301,0.338,0.334,0.234, all P <0.05), but negatively correlated with APN (r = -0.612, P <0.05). Conclusion This study provides theoretical and experimental evidence for the implementation of interventions, delay the progression of the disease, reduce the incidence of GDM, greatly reduce the incidence of adverse pregnancy outcomes, will create greater social value.