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정상임신 및 임신성 당뇨임신의 제대혈내 adiponectin 농도에 관한 연구

CONCENTRATION OF CORD SERUM ADIPONECTIN IN NORMAL AND GESTATIONAL DIABETIC PREGNANCIES

박은애|박미혜|김영주|조아라|전선희|조수진
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2011.09|Obstetrics & Gynecology Science|제54권 제09호|pp. 485-491

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키워드

AdipositySex characteristicsGestational diabetes mellitus임신성 당뇨제대혈내 adiponectin성별 간 두형태성지방축적도Cord serum adiponectin
주제분류산부인과학

초록

목적이번 연구의 목적은 정상임신군과 임신성 당뇨임신군의 비교를 통해 자궁내 환경의 차이가 제대혈내 adiponectin 농도에 어떠한 영향을주는지 알아보고자 하는 것이다. 연구방법2004년 1월부터 2009년 6월까지 이화여자대학교 목동병원 산부인과에서 35주 이후에 분만한 정상 산모군 204명과 임신성 당뇨로 진단받은 산모 204명을 대상으로 하여 연구를 시행하였다. 임신성 당뇨로 진단받은 204명의 산모 중에서 118명은 식이조절만으로 혈당을 조절하였고, 나머지 86명은 임신 기간 동안 인슐린을 투여 받았다. 분만 시 제대정맥혈액을 채취하여 원심분리 후, 효소면역측정법(enzyme-linked immunosorbent assay)을 사용하여 제대혈액내 adiponectin의 농도를 측정하였다. 결과제대혈내 adiponectin 농도는 정상임신군에 비해 임신성 당뇨로 진단받은 임신군에서 더 높은 수치를 나타내었다(P = 0.02). 정상임신군과임신성 당뇨임신군 모두에서 제대혈내 adiponectin 농도는 남아에 비해 여아가 높은 수치를 보였다(P = 0.04, P = 0.03). 정상임신군에서 임신 주수와 제대혈내 adiponectin 농도는 유의한 양의 상관관계를 보였다(r = 0.2374, P = 0.0129). 출생 시 주수와 성별을 보정한 경우, 정상임신군에서 출생 시 체중과 제대혈내 adiponectin 농도는 유의한 연관성이 없었다(P > 0.05). 임신성 당뇨를 진단받았던 임신군에서, 식이조절만으로 혈당을 관리한 군과 인슐린 치료를 받은 군의 제대혈내 adiponectin 농도는 통계적으로 유의한 차이가 없었다(P > 0.05). 결론제대혈내 adiponectin 농도가 정상임신 및 임신성 당뇨임신군 사이에서 차이를 보이고, 성별 간 두형태성을 나타내는 것은 이들의 자궁내환경이 다르기 때문이라고 생각된다. 임신성 당뇨임신군 및 여아에서 높은 제대혈내 adiponectin 농도를 보이는 것은, 이들의 증가된 지방축적도를 반영한 결과라 할 수 있을 것이다.

Abstract

Objective To investigate the effect of intrauterine environment on adiponectin level in cord blood through comparison of normal pregnancy group and gestational diabetes group. Methods This cross sectional study included women with: normal pregnancy (n = 204); and patients with gestational diabetes mellitus (GDM) (n = 204). Among GDM patients, 118 were managed with diet alone and 86 were insulin requiring. Cord serum adiponectin concentration at birth was measured by enzyme-linked immunosorbent assay. Results Cord serum adiponectin concentration was higher in GDM treatment pregnancies compared with normal pregnancies (P = 0.02). Cord serum adiponectin concentration was higher in female compared with male fetuses both normal and gestational diabetes pregnancies (P = 0.04, P = 0.03). In normal pregnancies, cord serum adiponectin concentration was positively correlated with gestational age (r = 0.2374, P < 0.02). In normal pregnancies, cord serum adiponectin concentration did not correlated with birth weight (r = -0.05, P > 0.05). Cord serum adiponectin concentration was not different between only diet treated women and insulin requiring women in GDM (P > 0.05). Conclusion Sex dimorphism for adiponectin and the change of adiponectin in GDM offsprings, fi rst appear in utero. Higher adiponectin levels in females or GDM offsprings refl ect increased adiposity of the fetuses.

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