血清性激素结合球蛋白水平与妊娠期糖耐量异常相关性研究

目的：通过比较SHBG水平在各孕周及不同程度糖耐量异常孕妇及相应孕周正常孕妇血清中的变化,探讨SHBG与妊娠期糖耐量异常相关性。方法：通过两步法筛选出不同程度糖耐量异常孕妇做实验组,选取相应孕周孕妇为对照组,测定其空腹血糖及SHBG水平并分析数据。结果：（1）在正常孕妇中SHBG浓度在孕期比非孕期显著增加,GDM组孕妇各孕周血中SHBG浓度均明显低于同孕周正常对照组,差异显著（P〈0.05）,且在小于妊娠24周及产后组中有极显著性差异（P〈0.01）。（2）在正常孕妇、单纯GCT阳性、糖耐量减低及GDM孕妇中,GDM组的SHBG浓度明显低于其他三组,差异显著（P〈0.05）;正常孕妇组的SHBG浓度明显高于其他三组,差异显著（P〈0.05）糖耐量异常组SHBG浓度低于单纯糖负荷试验异常组,但无统计学意义（P〉0.05）。结论：（1）在妊娠早中期测定SHBG浓度可以预测GDM,产后的SHBG水平对于判断GDM的预后也有重要的作用。（2）SHBG的降低与妊娠期糖耐量异常程度密切相关,通过孕期SHBG浓度的测定可以预知GDM的潜在人群,判定GDM的发生、发展及严重程度。

The relationship between the sex hormonebinding globulin and gestational glucose tolerance abnormal

Objective：By comparing the change of serum sex hormonebinding globulin（SHBG）concentration in the pregnant women of different gestational age and gestational glucose tolerance abnormal in different degree and the normal pregnant women in the same gestational age,to study the relationship between the sex hormonebinding globulin and gestational glucose tolerance abnormal.Methods：The pregnant women of gestational glucose tolerance abnormal of different degree was choosed to be the experimental group and the normal pregnant women in the corresponding gestational age was choosed to be the control group through the tow steps methods measuring the fasting glucose and the level of SHBG and analysistheing data.Results：1.The SHBG concentration in normal pregnancy was significantly higher compared with no pregnancy,The SHBG concentration in women with GDM,especially in the group before 24 gestational age and post partum,was significantly lower than that in normal pregnant women（P0.01）.2.Among normal pregnant women、abnormity of glucose challenge test、abnormity of glucose tolerance and GDM pregnant women,the SHBG concentration in women with GDM was significantly lower than other groups（P0.05）;the SHBG concentration in normal pregnant women was significantly higher than other groups（P0.05）;the SHBG concentration in OGTT abnormal pregnant women was similarly compared with that of GCT abnormal pregnant women（P0.05）.Conclusions：1.Gestational diabetes mellitus could be predicted by measuring the SHBG concentration in early pregnancy,the level of SHBG post partum was very important to judge GDM.2.The low SHBG concentration was tightly correlated with the degree of gestational glucose tolerance abnormal.determination of SHBG could predict the latent group for GDM and judge the coming on and development of GDM and its seriouse degree.