孕妇血清同型半胱氨酸的影响因素及其与妊娠期糖尿病的相关性研究

发布时间：2018-02-15 00:10

本文关键词： 妊娠期糖尿病同型半胱氨酸脂联素抵抗素胰岛素抵抗　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：了解福州市孕妇的基本情况、个人生活习惯、膳食结构与妊娠期糖尿病发生的关系，以及妊娠期糖尿病对妊娠结局的影响。了解血清同型半胱氨酸、胰岛素、脂联素和抵抗素与妊娠期糖尿病的关系以及影响血清同型半胱氨酸水平的因素，并探讨其导致胰岛素抵抗的机制。方法：在福建医科大学附属第一医院行常规产前检查并入院待产的49名妊娠期糖尿病孕妇和77名健康孕妇，采用统一问卷对孕妇进行调查，，内容包括：社会人口因素、生活习惯史、饮食习惯、营养保健品使用情况。采用食物频率法记录膳食摄入情况。所有接受调查的对象空腹采静脉血分离血清，用酶联免疫法测定同型半胱氨酸、脂联素、抵抗素和胰岛素浓度，从入院生化检测结果获得血红蛋白、总蛋白、白蛋白、球蛋白水平数据。结果： 1．孕后的交通方式（P=0.013）在GDM孕妇和正常孕妇间有所不同，而其他基本情况以及生活习惯在两组间未发现明显差别。 2．GDM孕妇的乳类（P=0.032）和水产类（P=0.007）食品平均每日摄入量高于正常孕妇。以菌藻类、肉类、水产类和蛋类食品为主的膳食模式（P=0.027）和以水果类为主的膳食模式（P=0.002）可能与GDM发生有关。 3．GDM的发生与产次有关（P=0.023），还会增加产时出血量（P=0.001），并影响新生儿Apgar评分（P=0.013）。 4．GDM孕妇和健康孕妇的血清同型半胱氨酸水平无明显差别，但GDM孕妇的血清脂联素浓度较低（P=0.011），球蛋白浓度较高（P=0.028）。 5．同型半胱氨酸与抵抗素的水平呈正相关（P＜0.001），抵抗素水平（P=0.002）、产前BMI（P=0.029）与HOMA-IR呈正相关。结论： 1．孕期应保持足够的身体活动，在膳食习惯方面，应该适当增加新鲜蔬菜的摄入量，并控制动物类食品摄入量，尤其是经产妇或确诊GDM的孕妇。 2．将同型半胱氨酸、抵抗素、BMI共同作为GDM的危险因素进行监测。
[Abstract]:Objective: to understand the basic situation of pregnant women in Fuzhou, the relationship between dietary structure and gestational diabetes mellitus, and the influence of gestational diabetes mellitus on pregnancy outcome, and to understand the serum homocysteine and insulin. The relationship between adiponectin and resistin and gestational diabetes mellitus and the factors influencing serum homocysteine level and the mechanism of insulin resistance were discussed. Methods: 49 pregnant women with gestational diabetes mellitus and 77 healthy pregnant women who received routine prenatal examination and were admitted to hospital at the first affiliated Hospital of Fujian Medical University were investigated with a unified questionnaire, which included: social and demographic factors. History of living habits, dietary habits, nutritional and health products use. Dietary intake was recorded by the method of food frequency. Serum samples were collected from all subjects on an empty stomach, and homocysteine and adiponectin were determined by enzyme-linked immunosorbent assay (Elisa). Resistin and insulin concentrations, obtained from the admission biochemical test results of hemoglobin, total protein, albumin, globulin level data. Results:. 1. The mode of transportation after pregnancy was different between GDM pregnant women and normal pregnant women, but there was no significant difference in other basic conditions and living habits between the two groups. 2. The average daily intake of milk (P0. 032) and aquatic (P0. 007)) of pregnant women with GDM was higher than that of normal pregnant women. The dietary patterns of bacteria, algae, meat, aquatic products and egg foods were mainly P0. 027) and the dietary pattern of P0. 002) might be related to the occurrence of GDM. 3. The occurrence of GDM was related to the number of births, and it also increased the amount of blood loss during labor and affected the Apgar score of neonates. 4. There was no significant difference in serum homocysteine levels between GDM pregnant women and healthy pregnant women, but the serum adiponectin concentration was lower and globulin concentration was higher in GDM pregnant women. 5. Homocysteine was positively correlated with resistin (P < 0.001), resistin level (P < 0.002) and pre-natal BMIP (0.029) was positively correlated with HOMA-IR. Conclusion:. 1. Adequate physical activity should be maintained during pregnancy. In dietary habits, the intake of fresh vegetables should be increased appropriately, and the intake of animal foods should be controlled, especially for pregnant women who have been diagnosed with GDM. 2. Homocysteine and resistin were used as risk factors of GDM.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.256

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