脂联素与妊娠期糖尿病危险因素筛查
Serum adiponectin determination and screening for the risk factors of gestational diabetes mellitus

目的:探讨妊娠期糖尿病(GDM)患者血清脂联素水平变化,并筛查GDM发生的危险因素。方法:采用ELISA法测定35例GDM患者、40例正常妊娠妇女(NGT组)血清脂联素水平,结合其他临床和生化指标,筛查GDM发生的危险因素。结果:GDM组脂联素水平较NGT组降低(t=7.763,P<0.001); logistic回归分析显示孕前BMI增高[OR(95%CI)=4.799(1.296～17.777)]及孕期脂联素水平降低[OR(95%CI)=0.238(0.085～0.666)]为GDM发生的危险因素; ROC曲线显示GDM发生的预测因素为孕前BMI(曲线下面积0.811,P<0.001)、糖尿病家族史(曲线下面积0.729,P<0.001)、孕期脂联素(曲线下面积0.694,P=0.007)。结论:孕前筛查糖尿病家族史、BMI可提前预测GDM的发生,并为辅助诊断提供依据; 孕期脂联素水平降低为GDM发生的危险因素; 脂联素可望成为GDM治疗的新药。
Aim: To investigate serum adiponectin level and screen the risk factors of gestational diabetes mellitus(GDM).Methods: ELISA was used to measure serum adiponectin level of 35 women with GDM and 40 normal gestational(NGT)women. Risk factors of GDM were analyzed combined with others clinical parameters.Results: Compared with NGT, adiponectin level of GDM group decreased significantly(t=7.763,P<0.001). The logistic regression analysis revealed that decreased serum adiponectin level during pregnancy and increased pre-gestational BMI were the risk factors of GDM[OR(95%CI)=0.238(0.085-0.666),4.799(1.296-17.777)]. ROC curve demonstrated that serum adiponectin level during pregnancy, clan history and pre-gestational BMI were the factors to predict the occurence of GDM(AUC=0.694,0.729,and 0.811,P<0.05).Conclusion: To screen clan history and BMI before pregnancy may predict the occurence of GDM and provide the evidence for early diagnosis. Decreased serum adiponectin during pregnancy was the risk factor of GDM, which demonstrates adiponectin could be the new drug to cure GDM