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目的探讨GDM患者血清Vaspin水平与IR的关系。方法选取2013年4~10月于我院产科行常规产前检查的孕妇176名,按75 g OGTT结果分为GDM组84例和糖耐量正常妊娠组(GNGT)92名,同时选取糖耐量正常未孕(NGT)者80名。检测各组血清Vaspin、瘦素(Leptin)、APN水平。行OGTT后检测各时点血糖、胰岛素、HbA_1c和血脂水平,稳态模型评估胰岛素抵抗指数(HOMAIR)。结果与NGT组比较,GDM组和GNGT组Vaspin水平升高,且GDM组较GNGT组高[(2.72±2.20)vs(1.84±1.57)ng/ml,P<0.05]。Pearson相关分析显示,GDM组Vaspin与HOMA-IR、TG呈正相关(r=0.387、0.218,P<0.05或P<0.01)。多元逐步回归分析显示,GDM组BMI-2(入组时BMI)、Vaspin、Leptin与HOMA-IR独立相关。二元Logistic回归分析表明,Vaspin和HOMA-IR是GDM的影响因素。结论 GDM患者Vaspin水平与IR相关,可能在GDM的发病机制中发挥重要作用,亦是GDM患者IS的重要标志。
Objective To investigate the relationship between serum Vaspin levels and IR in patients with GDM. Methods A total of 176 pregnant women with routine prenatal examination from April to October 2013 in our hospital were divided into two groups according to the results of 75 g OGTT: 84 cases of GDM group and 92 cases of normal glucose tolerance group (GNGT). Meanwhile, 80 non-pregnant (NGT). The levels of Vaspin, Leptin and APN in each group were detected. After OGTT, blood glucose, insulin, HbA1c and blood lipid levels were measured at each time point, and the homeostasis model was used to evaluate the insulin resistance index (HOMAIR). Results Compared with NGT group, the level of Vaspin in GDM group and GNGT group was significantly higher than that in GNGT group [(2.72 ± 2.20) vs (1.84 ± 1.57) ng / ml, P <0.05]. Pearson correlation analysis showed that there was a positive correlation between Vaspin and HOMA-IR and TG in GDM group (r = 0.387,0.218, P <0.05 or P <0.01). Multivariate stepwise regression analysis showed that BMI-2 (BMI), Vaspin and Leptin were independently associated with HOMA-IR in GDM group. Binary Logistic regression analysis showed that Vaspin and HOMA-IR were the influencing factors of GDM. Conclusion The level of Vaspin in GDM patients is related to IR, which may play an important role in the pathogenesis of GDM. It is also an important marker of IS in GDM patients.