不同时点糖代谢异常孕妇胰岛素抵抗与β细胞功能的研究

不同时点糖代谢异常孕妇胰岛素抵抗与β细胞功能的研究

程兰;韩玉环

【期刊名称】《天津医药》 【年(卷),期】2012(040)004

【摘要】目的:研究不同糖耐量状态人群胰岛素抵抗(IR)和β细胞分泌功能的区别.方法:收集孕前体质指数正常,无孕前合并症及妊娠期并发症,50 g葡萄糖筛查试验阳性患者504例,行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验.依美国糖尿病协会(ADA)诊断标准分组,计算并比较各组胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)以及反映葡萄糖刺激后胰岛素最大分泌功能的△PI/△PG.结果:不同时点糖代谢异常患者胰岛素释放特征不同,组间比较差异有统计学意义.与正常组(NGT)相比,葡萄糖耐量受损(GIGT)0、1、2及妊娠期糖尿病(GDM)组HOMA-IR均有不同程度增加,HOMA-β和△PI/△PG有不同程度下降,差异有统计学意义(P＜0.01),GIGT3与GIGT1、GDM差异有统计学意义(P＜0.05),GIGT0与GDM组△PI/△PG差异有统计学意义(P＜0,01).结论:妊娠期糖代谢异常患者不仅存在IR,还有β细胞功能的受损,GIGT的不同时点血糖异常者具有不同的代谢特异性,GIGT0、GIGT1与GDM相近似,GIGT3与NGT近似.%Objective: To reveal the difference of insulin resistance and pancreatic β-cell secretion in different time points of patients with impaired glucose tolerance. Methods: Five hundred and four patients with normal body mass index before pregnancy and 50 g GCT (+) were carried out the oral glucose tolerance test (OGTT) and insulin release test. According to American Diabetes Association (ADA) criteria patients

without other complications of pregnancy were divided into three groups. The insulin resistance index (HOMA-1R), β-cell function index (H0MA-β) and maximum glucose-stimulated insulin secretion of △PI/△PG were measured and compared between groups. Results: The characteristics of insulin level was significantly different in different time points of patients with abnormal glucose metabolism. Compared to normal control . Group, values of HOMA-IR were increased in gestational impaired glucose tolerance (GIGT) of fasting abnormality (GIGTO), GIGT of 1 h after oral glucose (G1GT1), GIGT of 2 h after oral glucose (GIGT2) and gestational diabetes mellitus (GDM) groups, but levels of HOMA-β and △ PI/△PG were significantly decreased (P < 0.01). There were significant differences between GIGT3, GIGTI and GDM groups (P < 0.05). There were also significant differences between G1GT0 group and GDM group (P < 0.01). Conclusion: Patients with abnormal glucose metabolism not only have stronger IR compared with normal pregnancies,but also have significant decline in pancreatic P-cell function. There are different characteristics of the metabolic types in different time points of GIGT. The characteristics of GIGTO and G1GT1 resembles that of GDM, and CIGT3 was similar to NGT. 【总页数】4页(352-355)

【关键词】葡萄糖代谢障碍;葡糖耐量试验;胰岛素抗药性;糖尿病,妊娠;葡糖耐受不良;胰岛素;β细胞功能;胰岛素释放试验

【作者】程兰;韩玉环

【作者单位】300100 天津医科大学妇产临床学院;天津医科大学第二医院 【正文语种】中文 【中图分类】 【文献来源】

https://www.zhangqiaokeyan.com/academic-journal-cn_tianjin-medical-journal_thesis/0201250569438.html 【相关文献】

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