妊娠糖尿病患者血清中脂肪素和脂肪连蛋白的水平及其与围产期结果的相关性

Mihai Muntean, Vlăduț Săsăran, Sonia-Teodora Luca, L. Suciu, Victoria Nyulas, C. Mǎrginean
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Pearson’s and Spearman’s correlation coefficients were calculated to determine the association of adipolin and adiponectin with anthropometric markers of obesity (body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold thickness (TST)), inflammation markers (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP)), and maternal glucose homeostasis parameters (fasting glucose, insulin, C peptide, glycosylated hemoglobin A1c (HbA1c), Insulin Resistance—Homeostatic Model Assessment (IR HOMA)). Results: There were no statistical differences between the adipolin value in patients with GDM compared to healthy patients (p = 0.65 at diagnosis and p = 0.50 prepartum) and in newborns from mothers with GDM compared to healthy mothers (p = 0.24). Adipolin levels are significantly higher in patients with GDM who gave birth via cesarean section (p = 0.01). 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引用次数: 0

摘要

研究目的本研究旨在调查健康孕妇和妊娠期糖尿病(GDM)孕妇在妊娠后三个月、产前以及新生儿血清中脂肪素和脂肪连蛋白的水平。研究方法本研究共纳入 55 名确诊为 GDM 的孕妇和 110 名健康孕妇。通过计算皮尔逊相关系数和斯皮尔曼相关系数,确定脂肪素和脂肪连素与肥胖的人体测量指标(体重指数(BMI)、中上臂围(MUAC)、三趾皮褶厚度(TST))之间的关系、炎症指标(中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、C反应蛋白(CRP))和孕产妇糖稳态参数(空腹血糖、胰岛素、C肽、糖化血红蛋白A1c(HbA1c)、胰岛素抵抗-稳态模型评估(IR HOMA))。结果与健康患者相比,GDM 患者的脂肪素值没有统计学差异(诊断时 p = 0.65,产前 p = 0.50);与健康母亲相比,GDM 母亲的新生儿脂肪素值也没有统计学差异(p = 0.24)。通过剖腹产分娩的 GDM 患者体内的 Adipolin 水平明显更高(p = 0.01)。在 GDM 患者中,脂肪素水平与产前的 HgA1c 呈正相关。我们发现,诊断时的母体脂肪素值与产前和新生儿脂肪素值呈正相关(分别为:r = 0.556,p = 0.001;r = 0.332,p = 0.013)。GDM 患者在诊断时和产前的脂肪连接蛋白水平明显较低(p = 0.0009 和 p = 0.02),但其水平在产前有所增加(5267 ± 2114 ng/mL vs. 6312 ± 3150 ng/mL p = 0.0006)。与健康母亲的新生儿相比,患 GDM 母亲的新生儿的脂肪连素水平较低(p < 0.0001)。两组产妇在诊断时和分娩前的母体脂肪连素值与产妇体重指数(BMI)、MUAC 和 IR HOMA 呈负相关。两组在剖宫产率方面没有差异(P > 0.99)。与健康产妇相比,GDM 患者发生不良事件的相对风险为 2.15 (95% CI 1.416 至 3.182),大畸形的几率比为 4.66 (95% CI 1.591 至 12.69)。结论在妊娠后三个月和产前,患有 GDM 的母亲和健康母亲的脂肪素水平没有差异。众所周知,脂肪素能提高胰岛素敏感性并减少炎症,但与脂肪连通素不同的是,它似乎不会导致 GDM 的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum Levels of Adipolin and Adiponectin and Their Correlation with Perinatal Outcomes in Gestational Diabetes Mellitus
Objectives: This study aimed to investigate the serum level of adipolin and adiponectin in healthy pregnant women and pregnant women with gestational diabetes mellitus (GDM) during the second trimester, the prepartum period, and in the newborns of these patients. Methods: A total of 55 women diagnosed with GDM and 110 healthy pregnant women were included in this study. Pearson’s and Spearman’s correlation coefficients were calculated to determine the association of adipolin and adiponectin with anthropometric markers of obesity (body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold thickness (TST)), inflammation markers (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP)), and maternal glucose homeostasis parameters (fasting glucose, insulin, C peptide, glycosylated hemoglobin A1c (HbA1c), Insulin Resistance—Homeostatic Model Assessment (IR HOMA)). Results: There were no statistical differences between the adipolin value in patients with GDM compared to healthy patients (p = 0.65 at diagnosis and p = 0.50 prepartum) and in newborns from mothers with GDM compared to healthy mothers (p = 0.24). Adipolin levels are significantly higher in patients with GDM who gave birth via cesarean section (p = 0.01). In patients with GDM, the adipolin level correlates positively with HgA1c in the prepartum period. We found a positive correlation between the maternal adipolin values at diagnosis and prepartum and neonatal adipolin (respectively: r = 0.556, p = 0.001; r = 0.332, p = 0.013). Adiponectin levels were significantly lower in patients with GDM at diagnosis and prepartum (p = 0.0009 and p = 0.02), but their levels increased prepartum (5267 ± 2114 ng/mL vs. 6312 ± 3150 ng/mL p = 0.0006). Newborns of mothers with GDM had lower adiponectin levels than newborns of healthy mothers (p < 0.0001). The maternal adiponectin value correlates negatively with maternal BMI, MUAC, and IR HOMA in both groups at diagnosis and prepartum. There were no differences between the groups in terms of cesarean rate (p > 0.99). The relative risk of occurrence of adverse events in patients with GDM compared to healthy ones was 2.15 (95% CI 1.416 to 3.182), and the odds ratio for macrosomia was 4.66 (95% CI 1.591 to 12.69). Conclusions: There was no difference in adipolin levels between mothers with GDM and healthy mothers during the second trimester and the prepartum period. Adipolin is known to enhance insulin sensitivity and reduce inflammation, but unlike adiponectin, it does not appear to contribute to the development of GDM.
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