目的 通过观察妊娠期糖尿病(GDM)患者Apelin水平的变化,探讨Apelin与GDM的关系.方法 2015年6月至12月在本院门诊做产前检查孕妇,按诊断标准分为GDM组(86例),对照组(健康孕妇组,90例).分别在做OGTT试验时及诊断为GDM患者饮食控制后,检测FBG、TC、TG、HDL-C、LDL-C、空腹胰岛素(FINS)、Apelin,计算出HOMA-IRI评价胰岛素抵抗的指标.结果 在做OGTT试验时,检测健康孕妇组的FBG、TG、LDL-C、FINS、HOMA-IRI、Apelin与GDM组比较差异有统计学意义(P＜0.05).GDM患者饮食控制后,FBG、FINS、HOMA-IRI、Apelin与对照组比较差异有统计学意义(P＜0.05).GDM组的TG、LDL-C与对照组比较差异无统计学意义(P＞0.05).结论 研究表明GDM患者存在高水平胰岛素抵抗,胰岛素抵抗可引起FBG、TG、LDL-C、FINS、HOMA-IRI、Apelin升高;而脂类代谢对Apelin水平升高无影响.胰岛素抵抗如何使GDM患者Apelin水平升高,可能是GDM发生的重要机制.%Objective To observe the change of serum Apelin of patients with gestational diabetes mellitus (GDM),and to investigate the relationship between Apelin and GDM.Methods 86 pregnant women with GDM and 90 normal pregnant women in our hospital from June 2015 to December 2015 were enrolled in the study.The plasma levels of fasting blood glucose (FBG),total cholesterol (TC),total triglyceride (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C),fasting insulin (FINS),Apelin were measured in both groups,and insulin resistance index (HOMA-IRI) was calculated.When both groups underwent OGTT test,they also underwent FBG,TC,TG,HDL-C,LDL-C,FINS,Apelin detection,which were measured in both groups again after GDM group received diet control.Results In the first detection,serum levels of FBG,TG,LDL-C,FINS,Apelin,HOMA-IRI in GDM group were significantly higher than those in normal group (P＜0.05).After GDM group received diet control,serum levels of FBG,FINS,Apelin,HOMA-IRI in GDM group were significantly higher than those in normal group (P＜0.05);there were no statistically significant differences in serum levels of TG,LDL-C between both groups (P＞0.05).Conclusions Significant increase of insulin resistance was found in patients with GDM compared with normal pregnant women.The increases of FBG,TG,LDL-C,FINS,HOMA-IRI,Apelin were associated with insulin resistance.But increased serum Apelin was not related to lipid metabolism.The increased serum Apelin caused by insulin resistance might play an important role in the mechanism of GDM.
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