OXLDL、TGF-β2、APN、瘦素及ApoC Ⅲ与妊娠合并糖尿病的相关性研究

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摘要目的分析妊娠中期血清氧化型低密度脂蛋白（OXLDL）、转化生长因子（TGF）-β2、载脂蛋白CⅢ（ApoC Ⅲ）、瘦素及脂联素（APN）水平与妊娠期糖尿病（GDM）发病的相关性。方法将2016年9月~2017年6月河北省直属机关第二门诊部200例产检的孕妇作为研究对象，于孕16~18周产检时对其血清进行采集，并通过ELISA法检测其血清OXLDL、TGF-β2、ApoC Ⅲ、瘦素及APN的水平；于孕24~28周时采取常规OGTT筛查，其中筛查结果正常的孕妇为对照组，诊断为GDM的孕妇为观察组，各100例。比较两组孕妇OXLDL、TGF-β2、ApoC Ⅲ、瘦素及APN的水平，比较两组妊娠结局与新生儿结局。根据血糖控制情况将观察组孕妇分为血糖控制欠佳组（55例）和血糖控制良好组（44例）。比较两组外周血OXLDL、TGF-β2、ApoC Ⅲ、瘦素及APN水平。对观察组孕妇外周血中OXLDL、TGF-β2、ApoC Ⅲ、瘦素及APN与空腹血糖分别进行相关性分析。结果观察组外周血OXLDL、TGF-β2、ApoC Ⅲ、瘦素水平均明显高于对照组，APN水平明显低于对照组，差异有统计学意义（P < 0.01）。观察组终止妊娠、胎膜早破、羊水过多、产后出血、妊娠高血压疾病、早产儿、巨大儿、新生儿窒息、新生儿肺炎发生率均明显高于对照组，新生儿Apgar评分明显低于对照组，差异有统计学意义（P < 0.01）。血糖控制欠佳组患者外周血OXLDL、TGF-β2、ApoC Ⅲ、瘦素水平均明显高于血糖控制良好组，APN水平明显低于血糖控制良好组，差异有统计学意义（P < 0.01）。观察组外周血中OXLDL、TGF-β2、ApoC Ⅲ、瘦素均与空腹血糖水平呈显著正相关（r=0.6315、0.7412、0.6155、0.5411，均P < 0.05），外周血中APN与空腹血糖水平呈显著负相关（r=-0.6613，P < 0.05）。结论 GDM患者外周血OXLDL、TGF-β2、ApoC Ⅲ、瘦素及APN的表达水平变化与疾病的发生、发展密切相关。

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	成丽岚1 成叶利2 马爱江1 魏兆轩1

关键词 ：妊娠糖尿病, 氧化型低密度脂蛋白, 转化生长因子, 瘦素, 载脂蛋白, 脂联素

Abstract：Objective To explore the relationship of OXLDL, TGF-β2, APN, leptin, ApoC Ⅲ and gestational diabetes mellitus (GDM). Methods From September 2016 to June 2017, 200 pregnant women in Department of Outpatient Internal Medicine, Hebei Province Directly under the Authority were selected as the research object, serum was collected during the 16-18 weeks of pregnancy, the serum levels of OXLDL, TGF-β2, ApoC Ⅲ, leptin and APN were detected by ELISA method. Routine OGTT screening was taken during the 24-28 weeks of pregnancy, the normal women as the control group and diagnosed with GDM as the observation group, with 100 cases in each group. Levels of OXLDL, TGF-β2, ApoC Ⅲ, leptin and APN in the two groups were compared, the pregnancy and neonatal outcome in the two groups were compared. Refer to the control of blood glucose, the observation group was divided into poor glucose control group (55 cases) and standard glucose control group (44 cases). Levels of OXLDL, TGF-β2, APN, leptin, ApoC Ⅲwere compared bettwen the two groups. Correlation analysis of fasting glucose and OXLD, TGF-β2, APN, leptin, ApoC Ⅲ were conducted in observation group. Results Levels of the OXLDL, TGF-β2, APN, leptin, ApoC Ⅲ were significantly higher in observation group than those of the control group, level of APN was significantly lower in the observation group than the control group, the differences were statistically significant (P < 0.01). The outcome of mother and fetus were better in control group than the observation group, and the Apgar scores was significantly lower in the observation group than the control group, the difference was statistically significant (P < 0.01). Levels of the OXLDL, TGF-β2, APN, leptin, ApoC Ⅲ were significantly higher in poor glucose control group than standard glucose control group, level of APN was significantly lower in poor glucose control group than the standard glucose control group, the difference was statistically significant (P < 0.01). In the observation group, levels of OXLD, TGF-β2, leptin, ApoC Ⅲ were positive related to the fasting blood glucose (r=0.6315, 0.7412, 0.6155, 0.5411, all P < 0.05), and APN was negatively related to the fasting blood glucose (r=-0.6613, P < 0.05). Conclusion The changes of OXLDL, TGF-β2, APN, leptin, ApoC Ⅲ level in patients with gestational diabetes mellitus are closely related to the occurrence and development of disease.

Key words： Gestational diabetes mellitus OXLDL TGF Leptin, APO APN

基金资助:河北省中管局中医药类科研计划（2013183）。

作者简介: 成丽岚（1975.8-），女，硕士，副主任医师；研究方向：内分泌与代谢病。

引用本文:

成丽岚1 成叶利2 马爱江1 魏兆轩1. OXLDL、TGF-β2、APN、瘦素及ApoC Ⅲ与妊娠合并糖尿病的相关性研究[J]. 中国医药导报, 2018, 15(12): 73-77.
CHENG Lilan1 CHENG Yeli2 MA Aijiang1 WEI Zhaoxuan1. The correlation of OXLDL, TGF-β2, APN, leptin and ApoC Ⅲ and gestational diabetes mellitus. 中国医药导报, 2018, 15(12): 73-77.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I12/73

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