关键词: 糖尿病, 妊娠；亲吻素；血糖；胰岛素抵抗；影响因素分析

Abstract: Objective　To evaluate the fasting serum level of Kisspeptin and its influence in patients with gestational diabetes mellitus（GDM）.Methods　A total of 120 pregnant women who underwent the 75 g oral glucose tolerance test（OGTT） at the Endocrinology Laboratory of the First Affiliated Hospital of Anhui Medical University from April to July 2016 were selected and divided into the GDM group（61 cases） and the normal glucose tolerance（NGT） group（59 cases） according to the 75 g　OGTT results.The GDM group and NGT group were further subgrouped according to body mass index（BMI）.Subjects with a BMI ≤ 24 kg/m2 were divided into the GDM-A subgroup（31 cases） and NGT-A subgroup（30 cases），and subjects with a BMI >24 kg/m2 were divided into the GDM-B subgroup（30 cases） and the NGT-B subgroup（29 cases）.Clinical data including age，weight during pregnancy，difference in weight，fasting blood glucose（FBG），1 h plasma glucose（PG），2 hPG，fasting insulin（FINS），1 h insulin（1 hINS），2 hINS，fasting C peptide，1 h C peptide，2 h C peptide and serum Kisspeptin level were collected.The insulin resistance index（HOMA-IR） and islet β-cell function index（HOMA-β） were calculated.Results　FBG，1 hPG，2 hPG，FINS，2 hINS，fasting C peptide，2 h C peptide，and HOMA-IR in the GDM group were all higher than those in the NGT group ，HOMA-β in the GDM group was lower than those in the NGT group（P<0.05）.The NGT-A subgroup had lower FINS，1 hINS，2 hINS，fasting C peptide，HOMA-IR and HOMA-β than the NGT-B subgroup（P<0.05）.HOMA-IR in the GDM-A subgroup was lower than that in the GDM-B subgroup（P<0.05）.Serum Kisspeptin level in the GDM group was higher than that in the NGT group（P<0.01），and serum Kisspeptin level in the GDM-A subgroup was higher than that in the NGT-A subgroup（P<0.05）.The GDM-B subgroup also had a higher serum Kisspeptin level than the NGT-B subgroup（P<0.05）.The serum Kisspeptin level was positively correlated with FBG，1 hPG，2 hPG，2 hINS，fasting C peptide，2 h C peptide and HOMA-IR，and negatively correlated with HOMA-β（P<0.05）.The serum Kisspeptin level was positively correlated with FBG and 2 hPG in the NGT group（P<0.05）.Conclusion　Serum Kisspeptin level in the GDM group increased significantly compared with the NGT group.Kisspeptin is positively correlated with FBG，1 hPG，2 hPG，2 hINS，fasting C peptide，2 h C peptide and HOMA-IR，and negatively correlated with HOMA-β.

Key words: Diabetes, gestational；Kisspeptins；Blood glucose；Insulin resistance；Root cause analysis