2种治疗方案妊娠期糖尿病患者Betatrophin与糖脂代谢的相关性*

Relationship between Betatrophin and glycolipid metabolism in different therapies of gestational diabetes mellitus*

摘要:

目的 探讨妊娠期糖尿病（GDM）孕妇血浆Betatrophin与糖脂代谢的关系，以及其评价治疗效果的预测价值。方法 选取2016年12月—2018年2月于青岛市市立医院进行规范产检并分娩的GDM孕妇60例，分为医学营养治疗组和胰岛素治疗组，每组30例。ELISA法检测血浆Betatrophin水平，全自动生化分析仪 检测空腹血糖（FPG）、糖化血红蛋白（HbA1c）、糖化血清蛋白（GSP）、空腹胰岛素（FINS）、甘油三酯 （TG）、总胆固醇（TC），根据公式计算稳态胰岛素评价指数（HOMA-IR）。结果 医学营养治疗组GDM孕妇血浆Betatrophin与FPG、TG、FINS、HOMA-IR呈正相关（r?=0.621、0.417、0.380和0.624，均P?<0.05），与TC无关（P?>0.05）；胰岛素治疗组GDM孕妇围分娩期血浆Betatrophin与TG、TC、FINS、HOMA-IR呈负相关（r?=-0.128、-0.236、-0.200和-0.387，均P?<0.05），与FPG无关（P?>0.05）。所有GDM孕妇治疗后血浆Betatrophin、HbA1c、GSP与治疗前比较，差异有统计学意义（P?<0.05），均降低。Betatrophin与GSP呈正相关（r?=0.406，P?<0.05），与HbA1c无关（P?>0.05）。结论 GDM不同治疗方案中血浆Betatrophin参与糖脂代谢程度不同，Betatrophin或可作为一种监测和评估治疗效果的指标。

Abstract:

Objective To explore the relation between plasma Betatrophin and glycolipid metabolism in the pregnant with gestational diabetes mellitus (GDM) treated with medical nutrition or insulin, and the predictive value of evaluating therapeutic effect. Methods A total of 60 GDM women were selected and equally divided into the medical nutrition therapy group (as the medical group) and the insulin therapy group (as the insulin group), whose plasma Betatrophin was detected with Elisa. The biochemical indexes were detected by automatic biochemical analyzer, including fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), glycosylated serum protein (GSP), fasting insulin (FINS), triglycerides (TG), and total cholesterol (TC). The insulin resistance index HOMA-IR was calculated by formula. Results The plasma Betatrophin was positively correlated with FPG, TG, FINS and HOMA-IR (r?=?0.621, 0.417, 0.380 and 0.624, P??0.05) in the medical group, negatively correlated with TG, TC, FINS, HOMA-IR (r?=?-0.128, -0.236, -0.200 and -0.387, P??0.05) in the insulin group. The plasma Betatrophin, HbA1c and GSP were decreased after the treatment in both groups and the differences were statistically significant (P?< 0.05). The plasma Betatrophin positively correlated with GSP (r?=?0.406, P??0.05). Conclusions The involvement of Betatrophin in glycolipid metabolism is different in two groups. Betatrophin may be an indicator for monitoring and evaluating treatment effect.