妊娠期糖尿病孕妇血清YKL-40 Irisin水平与糖脂代谢及胰岛素抵抗的关系研究

doi:10.3969/j.issn.1006-6233.2022.02.016

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摘要 目的: 探讨妊娠期糖尿病(GDM)孕妇血清人软骨糖蛋白-39(YKL-40)、鸢尾素(Irisin)水平与糖脂代谢及胰岛素抵抗(IR)的相关性。方法: 选取2018年1月至2021年1月海南省人民医院诊治的148例GDM孕妇作为GDM组,另按同期、孕周匹配原则选择于我院产科行常规检查的健康孕妇50例为对照组,检测并比较两组血清YKL-40、Irisin、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、高/低密度脂蛋白胆固醇(H/LDL-C)、甘油三酯(TG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-B)。采用Pearson相关性分析检验血清YKL-40、Irisin与其他指标的相关性。结果: 与对照组相比,GDM组血清YKL-40、FPG、2hFPG、HbAlc、TC、LDL-C、TG、FINS水平及HOMA-IR均较高,而Irisin、HDL-C水平及HOMA-B较低(P<0.05);Pearson相关性分析结果显示,GDM患者血清YKL-40与FPG、2hFPG、TC、LDL-C、TG、FINS、HOMA-IR正相关,与HDL-C、HOMA-B负相关(P<0.05);血清Irisin与FPG、2hFPG、HbAlc、TC、LDL-C、TG、FINS、HOMA-IR负相关,与HDL-C、HOMA-B正相关(P<0.05)。结论: GDM孕妇血清YKL-40呈高表达、Irisin呈低表达,且其表达与糖脂代谢和胰岛素抵抗关系密切,在GDM的诊治中具有一定临床价值。

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关键词 ：妊娠期糖尿病, 人软骨糖蛋白, 鸢尾素, 糖脂代谢, 胰岛素抵抗, 相关性

Abstract：Objective: To investigate the correlation of serum human cartilage glycoprotein-39 (YKL-40) and irisin levels with glucose and lipid metabolism and insulin resistance (IR) in pregnant women with gestational diabetes mellitus (GDM). Methods: A total of 148 pregnant women with GDM (GDM group) admitted to Hainan Provincial People's Hospital between January 2018 and January 2021were enrolled in this study. Meanwhile, with the gestational age matching principle, 50 healthy pregnant women who received routine examinations in obstetric department of the hospital were selected as the control group. The levels of serum YKL-40, irisin, fasting plasma glucose (FPG), 2 hours postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbAlc), total cholesterol (TC), high/low density lipoprotein cholesterol (H/LDL-C), triglyceride (TG) and fasting insulin (FINS) were compared between the two groups. The insulin resistance index (HOMA-IR) and insulin secretion index (HOMA-B) were calculated. Pearson correlation analysis was performed to test the correlation of serum YKL-40 and irisin with other indicators. Results: Compared with the control group, the GDM group had higher levels of serum YKL-40, FPG, 2hFPG, HbAlc, TC, LDL-C, TG, FINS and HOMA-IR, and lower levels of irisin, HDL-C and HOMA-B (P<0.05). Pearson correlation analysis showed that serum YKL-40 was positively correlated with FPG, 2hFPG, TC, LDL-C, TG, FINS and HOMA-IR, and negatively correlated with HDL-C and HOMA-B (P<0.05). Serum irisin was negatively correlated with FPG,2hFPG, HbAlc, TC, LDL-C, TG, FINS and HOMA-IR, and positively correlated with HDL-C and HOMA-B (P<0.05). Conclusion: Pregnant women with GDM have high serum YKL-40 level and low irisin level. The two are closely related to glucose and lipid metabolism and insulin resistance, with certain clinical value in the diagnosis and treatment of GDM.

Key words： Gestational diabetes mellitus Human cartilage glycoprotein Irisin Glucose and lipid metabolism Insulin resistance Correlation

基金资助:海南省自然科学基金项目,(编号:30363)

通讯作者: 龚护民

引用本文:

宋杰, 王广铭, 龚护民, 郑林媚. 妊娠期糖尿病孕妇血清YKL-40 Irisin水平与糖脂代谢及胰岛素抵抗的关系研究[J]. 河北医学, 2022, 28(2): 259-263.
SONG Jie, et al. Relationship of Serum YKL-40 and Irisin Levels with Glucose and Lipid Metabolism and Insulin Resistance in Pregnant Women with Gestational Diabetes Mellitus. HeBei Med, 2022, 28(2): 259-263.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.02.016 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I2/259