Karatas Ahmet, Tunçay Işikkent Nilüfer, Ozlü Tülay, Demirin Hilmi
Department of Obstetrics and Gynecology, Medical Faculty, Abant Izzet Baysal University , Bolu , Turkey .
Gynecol Endocrinol. 2014 May;30(5):355-8. doi: 10.3109/09513590.2014.887670. Epub 2014 Feb 10.
Adiponectin, resistin and visfatin are thought to play role in the pathophysiology of gestational diabetes (GDM). In this study, we aimed to investigate the association of maternal second trimester serum resistin and visfatin levels with GDM.
Screening and diagnosis for GDM was performed between the 24-28th gestational weeks. About 40 women diagnosed with GDM and 40 non-diabetic women constituted the study and control groups, respectively. Groups were compared for second trimester maternal serum resistin, visfatin and HbA1c levels, HOMA-IR and postpartum 75 g OGTT results.
Mean serum resistin (p = 0.071) and visfatin (p = 0.194) levels were similar between the groups. However, mean BMI (p = 0.013), HOMA-IR (p = 0.019), HbA1c (p < 0.0001) and birth weight (p = 0.037) were significantly higher in GDM group compared to controls. Type 2 diabetes and impaired glucose tolerance were detected in 2 (5%) and 7 (20%) women in the GDM group, respectively, with 75 g OGTT performed at the postpartum 6th week. Resistin levels of patients with GDM and postpartum glucose intolerance were higher than those with GDM but no postpartum glucose intolerance (p = 0.012). Visfatin levels in the GDM group showed a positive correlation with biparietal diameter, head circumference, abdominal circumference and femur length (p < 0.05).
Maternal serum resistin and visfatin levels are unchanged in GDM. In patients with GDM, second trimester resistin levels may be predictive for postpartum glucose intolerance and second trimester visfatin levels may be related with fetal biometric measurements. Further larger studies are needed.
脂联素、抵抗素和内脂素被认为在妊娠期糖尿病(GDM)的病理生理过程中发挥作用。在本研究中,我们旨在探讨孕中期母体血清抵抗素和内脂素水平与GDM的关联。
在妊娠第24 - 28周进行GDM的筛查和诊断。约40例被诊断为GDM的女性和40例非糖尿病女性分别构成研究组和对照组。比较两组孕中期母体血清抵抗素、内脂素和糖化血红蛋白(HbA1c)水平、稳态模型评估胰岛素抵抗(HOMA-IR)以及产后75克口服葡萄糖耐量试验(OGTT)结果。
两组间血清抵抗素(p = 0.071)和内脂素(p = 0.194)的平均水平相似。然而,与对照组相比,GDM组的平均体重指数(BMI,p = 0.013)、HOMA-IR(p = 0.019)、HbA1c(p < 0.0001)和出生体重(p = 0.037)显著更高。在产后第6周进行75克OGTT检查时,GDM组分别有2例(5%)和7例(20%)女性被检测出患有2型糖尿病和糖耐量受损。GDM患者且产后糖耐量异常者的抵抗素水平高于GDM患者但产后糖耐量正常者(p = 0.012)。GDM组内脂素水平与双顶径、头围、腹围和股骨长度呈正相关(p < 0.05)。
GDM患者母体血清抵抗素和内脂素水平无变化。在GDM患者中,孕中期抵抗素水平可能预测产后糖耐量异常,孕中期内脂素水平可能与胎儿生物测量值相关。需要进一步开展更大规模的研究。