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目的探讨血清脂肪酸结合蛋白4(FABP4)、成纤维细胞生长因子21(FGF21)、摄食抑制因子-1(Nesfatin-1)与妊娠期糖尿病(GDM)患者胰岛素抵抗(IR)的关系。方法选取该院2012年3月-2016年5月收治的GDM患者60例(GDM组),另选取同期体检健康孕妇60例(对照组)。测定两组患者空腹血清FABP4、FGF21及Nesfatin-1浓度,同时测定两组患者空腹血糖(FPG)、血脂相关指标以及空腹胰岛素(FINS)水平。计算胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、早期胰岛素分泌功能指数(△I_(30)/△G30)及胰岛素敏感性指数(ISI)。采用Spearman秩相关分析血清FABP4、FGF21、Nesfatin-1与IR指数的关系。结果两组患者甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、FPG、FINS、FABP4、FGF21、Nesfatin-1水平及HOMA-IR、△I_(30)/△G30、HOMA-β、ISI比较,差异均有统计学意义(均P<0.05)。Spearman秩相关分析显示,FABP4、FGF21、Nesfatin-1与HOMA-IR呈正相关(P<0.05);与HOMA-β、ISI呈负相关(P<0.05)。结论 GDM患者血清FABP4、FGF21、Nesfatin-1浓度较健康者明显升高,并与IR明显相关,提示FABP4、FGF21、Nesfatin-1可能参与了GDM及IR的病理生理过程。
Objective To investigate the relationship between serum FABP4, FGF21, Nesfatin-1 and insulin resistance (IR) in patients with gestational diabetes mellitus (GDM). Methods Sixty patients with GDM (GDM group) admitted to our hospital from March 2012 to May 2016 were selected, and 60 healthy pregnant women (control group) were selected during the same period. Fasting serum FABP4, FGF21 and Nesfatin-1 levels were measured in both groups. Fasting plasma glucose (FPG), serum lipid related indicators and fasting insulin (FINS) levels were measured in both groups. HOMA-β, HOMA-IR, △ I_ (30) / △ G30) and insulin sensitivity index (ISI) were calculated. Spearman rank correlation analysis of serum FABP4, FGF21, Nesfatin-1 and IR index relationship. Results The levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), FPG, FINS, FABP4, FGF21, Nesfatin-1 and HOMA-IR, / △ G30, HOMA-β, ISI, the differences were statistically significant (P <0.05). Spearman rank correlation analysis showed that there was a positive correlation between FABP4, FGF21 and Nesfatin-1 and HOMA-IR (P <0.05), but negatively correlated with HOMA-β and ISI (P <0.05). Conclusions Serum levels of FABP4, FGF21 and Nesfatin-1 in patients with GDM are significantly higher than those in healthy subjects and significantly correlated with IR, suggesting that FABP4, FGF21 and Nesfatin-1 may be involved in the pathophysiological processes of GDM and IR.