Palik Eva, Baranyi Eva, Melczer Zsolt, Audikovszky Maria, Szöcs Albert, Winkler Gábor, Cseh Károly
3rd Department of Medicine, Semmelweis University, H-1125 Kútvölgyi u 4, Budapest, Hungary.
Diabetes Res Clin Pract. 2007 Jun;76(3):351-7. doi: 10.1016/j.diabres.2006.09.005. Epub 2006 Sep 28.
To study fasting biologically active serum ghrelin (RIA) and resistin (ELISA) levels in different trimesters of pregnancy (HP, n=45, 15 in each) and in gestational diabetes mellitus (GDM, n=30) compared to non-pregnant healthy women (NP, n=40) in correlation with TNF-alpha, soluble (s)TNF-receptor (R)-1, -2, leptin (ELISA), C-peptide (Cp, RIA) and Cp/blood glucose ratio (bg).
Cross-sectional case control study.
Acylated ghrelin levels were significantly increased (p<0.0001) in the 2nd (377+/-38pg/ml, X+/-S.D.) and decreased in the 3rd trimester (252+/-36) and in GDM (226+/-21) compared to NP controls (309+/-20) and HP women in the 1st trimester (314+/-41). Serum resistin levels were higher in the 1st (8.5+/-2.6ng/ml), 2nd (10.2+/-2.1) and 3rd (13.1+/-3.6) trimesters of pregnancy and in GDM (15.7+/-3.5) than in NP controls (6.5+/-2.3). Significant (p<0.01) negative linear correlations were found among fasting serum ghrelin and body mass index (BMI), the fasting C-peptide (Cp) level, C-peptide/blood glucose (Cp/bg) ratio, TNF-alpha, soluble (s)TNFR-2, leptin and resistin concentrations in both, HP and GDM groups. Significant positive correlations were observed between serum acylated ghrelin and adiponectin, and between BMI and fasting Cp, Cp/bg, TNF-alpha, sTNFR-1, -2 and leptin levels in both pregnant groups.
Increased fasting serum acylated ghrelin concentrations in the 2nd trimester may associate with weight gain during pregnancy. Hyperresistinemia may also be associated with the pregnancy-induced insulin resistance. A negative regulatory feed-back mechanism between resistin, TNF-alpha and ghrelin may be hypothesized.
研究妊娠不同阶段（健康妊娠组，HP，n = 45，每组15例）和妊娠期糖尿病（GDM，n = 30）患者空腹时生物活性血清胃饥饿素（放射免疫分析法，RIA）和抵抗素（酶联免疫吸附测定法，ELISA）水平，并与非妊娠健康女性（NP，n = 40）进行比较，同时分析其与肿瘤坏死因子-α（TNF-α）、可溶性（s）肿瘤坏死因子受体（R）-1、-2、瘦素（ELISA）、C肽（Cp，RIA）及Cp/血糖比值（bg）的相关性。
横断面病例对照研究。
与NP对照组（309±20）及HP组孕早期女性（314±41）相比，HP组孕中期（377±38pg/ml，X±标准差）酰化胃饥饿素水平显著升高（p<0.0001），孕晚期（252±36）及GDM组（226±21）降低。妊娠1、2、3期及GDM组（15.7±3.5）血清抵抗素水平高于NP对照组（6.5±2.3）。在HP组和GDM组中，空腹血清胃饥饿素与体重指数（BMI）、空腹C肽（Cp）水平、C肽/血糖（Cp/bg）比值、TNF-α、可溶性（s）肿瘤坏死因子受体-2（TNFR-2）、瘦素及抵抗素浓度之间均存在显著（p<0.01）负线性相关。在两组妊娠人群中，血清酰化胃饥饿素与脂联素之间、BMI与空腹Cp、Cp/bg、TNF-α、s肿瘤坏死因子受体-1、-2及瘦素水平之间均存在显著正相关。
孕中期空腹血清酰化胃饥饿素浓度升高可能与孕期体重增加有关。高抵抗素血症也可能与妊娠诱导的胰岛素抵抗有关。可以推测抵抗素、TNF-α和胃饥饿素之间存在负调节反馈机制。
