血清不同类型维生素与妊娠期糖尿病病人胰岛素抵抗、血清细胞因子的相关性

    Correlation of different types of serum vitamins with insulin resistance and serum cytokines in patients with gestational diabetes mellitus

    • 摘要:
      目的 分析血清不同类型维生素与妊娠期糖尿病(GDM)病人胰岛素抵抗、血清细胞因子的相关性。
      方法 选择在产科门诊接受口服葡萄糖耐量试验的孕24~28周孕妇150例,其中合并GDM病人38例作为A组,糖耐量正常孕妇112例作为B组,另选取同期健康体检育龄期女性50名作为C组。检测3组血清维生素(Vit)A、VitC、VitD、VitE和细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6、趋化素、脂联素(APN)水平,检测血糖和空腹胰岛素(F-Ins)及服糖后2 h胰岛素(2h-Ins)水平,计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(HOMA-ISI)。
      结果 A组血清VitA、VitC水平与B、C组差异均无统计学意义(P>0.05),VitD、VitE水平和HOMA-ISI均低于B、C组(P<0.05),TNF-α、IL-1β、IL-6、趋化素和F-Ins、2h-Ins水平及HOMA-IR均高于B、C组(P<0.05)。GDM病人血清VitD、VitE水平与F-Ins、2h-Ins、TNF-α、IL-1β、IL-6、趋化素水平和HOMA-IR均呈负相关关系(P<0.05),与APN水平和HOMA-ISI均呈正相关关系(P<0.05)。
      结论 GDM病人VitD、VitE不足可能与胰岛素抵抗加剧、促炎因子分泌增多有关。

       

      Abstract:
      Objective To study the correlation between different types of serum vitamins and insulin resistance, serum cytokines in patients with gestational diabetes mellitus (GDM).
      Methods A total of 150 pregnant women of 24-28 weeks' gestation who underwent oral glucose tolerance test in the obstetrics outpatient clinic were selected, among which 38 patients with combined GDM served as group A, 112 pregnant women with normal glucose tolerance served as group B, and 50 women of childbearing age who underwent health checkups during the same period of time were selected as group C.Serum vitamin (Vit) A, VitC, VitD, VitE and cytokine tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, chemotaxis, and adiponectin (APN) levels were detected in the three groups, the levels of blood glucose and fasting insulin (F-Ins) and 2 h insulin after glucose (2h-Ins) were tested, and the index of insulin resistance (HOMA-IR) and insulin sensitivity index (HOMA-ISI) were calculated.
      Results There was no significant difference in serum VitA and VitC among group A, group B and group C (P > 0.05).The serum VitD, VitE and HOMA-ISI level in group A were significantly lower than those in group B and group C (P < 0.05), while serum F-Ins, 2h-Ins, TNF-α, IL-1β, IL-6, chemerin and HOMA-IR level were significantly higher than those in group B and group C (P < 0.05).The level of VitD and VitE were negatively correlated with serum F-Ins, 2h-Ins, TNF-α, IL-1β, IL-6, chemerin and HOMA-IR level (P < 0.05), and positively correlated with HOMA-ISI level and serum APN (P < 0.05).
      Conclusions VitD and VitE deficiency in patients with GDM may be associated with increased insulin resistance and secretion of proinflammatory factors.

       

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