妊娠期糖尿病孕妇血清CST、humanin、VAP-1与糖脂代谢及胰岛素抵抗的关系研究

目的:探讨妊娠期糖尿病(GDM)孕妇血清皮质醇激素抑制素(CST)、humanin、血管黏附蛋白-1(VAP-1)与糖脂代谢及胰岛素抵抗的关系。方法:选择2017年1月至2019年10月我院妇产科门诊收治的79例GDM患者(GDM组),另选取同期到我院行产检的52例正常妊娠孕妇(NGT组)。检测并比较血清CST、humanin、VAP-1水平,分析CST、humanin、VAP-1与GDM患者糖脂代谢、胰岛素抵抗的相关性,并作二元Logistic回归分析探讨GDM发病的危险因素。结果:GDM组血清CST、humanin、空腹C肽(FC-P)、C-P峰值/FC-P、胰岛素β细胞功能指数HOMA-β(C-P)]水平低于NGT组(P<0.05),VAP-1、空腹血糖(FPG)、胰岛素抵抗指数HOMA-IR(C-P)]、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于NGT组(P<0.05)。Pearson相关性分析结果显示血清CST水平与FPG、HOMA-IR(C-P)呈负相关(P<0.05),与FC-P、C-P峰值/FC-P、HOMA-β(C-P)呈正相关(P<0.05)。humanin水平与TG、FPG、HOMA-IR(C-P)呈负相关,与FC-P、C-P峰值/FC-P、HOMA-β(C-P)呈正相关(P<0.05)。VAP-1与TG、FPG、HOMA-IR(C-P)呈正相关(P<0.05),与FC-P、C-P峰值/FC-P、HOMA-β(C-P)呈负相关(P<0.05)。二元Logistic回归分析结果显示CST、humanin、HOMA-β(C-P)水平降低,年龄、BMI、LDL-C、VAP-1、HOMA-IR(C-P)水平升高是GDM发病的危险因素(P<0.05)。结论:GDM患者血清CST、humanin水平降低,VAP-1水平升高,三者均参与GDM发病和胰岛素抵抗。CST与糖代谢紊乱有关,humanin、VAP-1与糖脂代谢异常有关。

The Relationship between Serum CST, Humanin, VAP-1 and Glucose and Lipid Metabolism and Insulin Resistance in Pregnant Women with Gestational Diabetes Mellitus

Objective: To investigate the relationship between serum cortistatin(CST), humanin and vascular adhesion protein-1(VAP-1), glucose and lipid metabolism and insulin resistance in pregnant women with gestational diabetes mellitus(GDM). Methods: 79 patients with GDM(GDM group) admitted to the department of Obstetrics and gynecology of our hospital from January 2017 to October2019 were selected. In addition, 52 normal pregnant women(NGT group) who came to our hospital for antenatal examination in the same period were selected. Serum level of CST, humanin, and VAP-1 were detected and compared, and the correlation between CST,humanin, and VAP-1 and glucose and lipid metabolism and insulin resistance in PATIENTS with GDM were analyzed. Binary Logistic regression analysis was conducted to explore the risk factors for GDM. Results: The serum CST, humanin, fasting C peptide(FC-P), C-P peak/FC-P, insulin β cell function index HOMA-β(C-P)] levels in GDM group were lower than those in NGT group(P<0.05), VAP-1,fasting plasma glucose(FPG), insulin resistance index HOMA-IR(C-P)], triglycerides(TG), low-density lipoprotein cholesterol(LDL-C) levels were higher than those in NGT group(P<0.05). Pearson correlation analysis showed that serum CST level were negatively correlated with FPG and HOMA-IR(C-P)(P<0.05), and positively correlated with FC-P, C-P peak/FC-P, and HOMA-β(C-P)(P<0.05). humanin level were negatively correlated with TG, FPG, HOMA-IR(C-P), and positively correlated with FC-P, C-P peak/FC-P, and HOMA-β(C-P)(P<0.05). VAP-1 were positively correlated with TG, FPG, HOMA-IR(C-P)(P<0.05), and negatively correlated with FC-P, C-P peak/FC-P and HOMA-β(C-P)(P<0.05). Binary Logistic regression analysis showed that CST, humanin,HOMA-β(C-P) decreased, and age, BMI, LDL-C, VAP-1, HOMA-IR(C-P) increased were risk factors of GMD(P<0.05). Conclusion:Serum CST and humanin levels of GDM patients are decreased, and serum VAP-1 level is increased. All of them are involved in the incidence of GDM and insulin resistance. CST is related to glucose and lipid metabolism disorder, and humanin and VAP-1 are related to glucose and lipid metabolism abnormality.