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妊娠及产后妊娠期糖尿病妇女与非妊娠期糖尿病妇女血清 vaspin 水平。

Serum vaspin levels in women with and without gestational diabetes mellitus during pregnancy and postpartum.

机构信息

Clinic of Obstetrics and Gynaecology, 424 Military Hospital, 3rd Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Cytokine. 2013 Jan;61(1):127-32. doi: 10.1016/j.cyto.2012.09.006. Epub 2012 Oct 5.

Abstract

Although vaspin is regarded an insulin-sensitizing adipokine, its role in gestational diabetes mellitus (GDM) is currently unknown. We aimed to evaluate serum vaspin levels and their correlation with insulin resistance in women with and without GDM. Forty-four women with GDM [GDM Group - 20 managed with diet only (GDM-diet) and 24 with diet plus insulin (GDM-insulin)] and 44 age-matched pregnant women with normal glucose tolerance (Control Group) were studied. Serum glucose, lipids, uric acid, insulin and vaspin were measured at the 2nd and 3rd trimester of pregnancy and postpartum. The quantitative insulin sensitivity check index (QUICKI) and homeostasis model of assessment-insulin resistance (HOMA-IR) were calculated. Circulating vaspin levels decreased significantly postpartum in all groups (p<0.001), but did not differ between GDM or GDM Subgroups and Control Group in any time point. At the 3rd trimester of pregnancy vaspin was positively correlated to insulin (p=0.022), HOMA-IR (p=0.016) and triglycerides (p=0.033) and negatively correlated to QUICKI (p=0.016) in the GDM women, but not in the Controls. These correlations were not observed at the 2nd trimester or postpartum. Vaspin, in contrast to HOMA-IR, could not independently predict GDM in binary logistic regression. In patients with GDM, insulin treatment did not affect vaspin levels. In conclusion, our data suggest that vaspin levels gradually decrease from the 2nd trimester to postpartum; however, decreases are similar between women with or without GDM. Serum vaspin cannot independently predict GDM and it is not affected by the degree of glucose metabolism deregulation or the exogenous administration of insulin.

摘要

尽管 vaspin 被认为是一种胰岛素增敏脂肪因子,但它在妊娠期糖尿病(GDM)中的作用尚不清楚。我们旨在评估患有和不患有 GDM 的女性的血清 vaspin 水平及其与胰岛素抵抗的相关性。研究了 44 名患有 GDM 的女性[GDM 组-20 名仅接受饮食管理(GDM-饮食),24 名接受饮食加胰岛素治疗(GDM-胰岛素)]和 44 名年龄匹配的糖耐量正常的孕妇(对照组)。在妊娠第 2 期和第 3 期及产后测量血清葡萄糖、脂质、尿酸、胰岛素和 vaspin。计算定量胰岛素敏感性检查指数(QUICKI)和稳态模型评估胰岛素抵抗(HOMA-IR)。所有组的循环 vaspin 水平在产后均显著下降(p<0.001),但在任何时间点 GDM 或 GDM 亚组与对照组之间均无差异。在妊娠第 3 期,GDM 女性的 vaspin 与胰岛素(p=0.022)、HOMA-IR(p=0.016)和甘油三酯(p=0.033)呈正相关,与 QUICKI(p=0.016)呈负相关,但在对照组中则没有。这些相关性在妊娠第 2 期或产后未观察到。与 HOMA-IR 不同,vaspin 不能在二元逻辑回归中独立预测 GDM。在 GDM 患者中,胰岛素治疗不会影响 vaspin 水平。总之,我们的数据表明,血清 vaspin 水平从妊娠第 2 期到产后逐渐下降;然而,患有或不患有 GDM 的女性之间的下降相似。血清 vaspin 不能独立预测 GDM,也不受葡萄糖代谢失调程度或外源性胰岛素给药的影响。

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