妊娠晚期糖尿病患者胰岛素抵抗与胰岛素分泌的临床研究.docVIP

· 122 · · 专 题 研 究 · 妊娠晚期糖尿病患者胰岛素抵抗与胰岛素分泌的临床研究 郭艳蒲，崔淑娟 【摘要】 目的 探讨妊娠晚期糖尿病 (GDM) 患者胰岛素抵抗 (IR) 与胰岛素分泌之间的关系。方法 选取在 我院住院分娩的足月孕妇133例，根据75g糖耐量试验 (OGTT 试验)结果分为妊娠期糖尿病 (GDM) 组49例，妊娠 期糖耐量受损 (GICT) 组39例，以及正常妊娠者45例为对照组 (NGT 组)。计算出各组的胰岛素分泌指数 (HOMA -IS), 胰岛素抵抗指数 (HOMA-IR) 及β细胞功能指数，并进行对比分析。结果 GDM、GIGT、NGT 组胰岛素分 泌功能(△I60、△I60/△G60及HOMA- β) 依次递增 (P0.05), 胰岛素抵抗程度 (HOMA-IR) 依次递减 (P 0.05)。GDM 组及GIGT 组通过饮食等治疗，与NGT 组在巨大儿、羊水过多、剖宫产率及1min 阿普加(1 min Apgar) 评分、5 min Apgar 评分比较，差异均无统计学意义 (P0.05)。 结论 胰岛素分泌功能的缺陷以及胰岛素抵抗共同导 致了GDM,CIGT 属于GDM 其中的一个阶段，应在此期对患者进行监控和治疗。 【关键词】 妊娠末期；胰岛素抵抗；胰岛素分泌 【中图分类号】 R714.147 【文献标识码】 A 【文章编号】1007-9572(2011)01-0122-03 Association between Insulin Resistance and Insulin Secretion during Gestational Diabetes Mellitus GUO Yan -pu,CUl Shu-juan. The First Central Hospital of Baoding,Baoding 071000,China 【Abstract】 Objective To explore the association between insulin resistance(IR) and insulin secretion during gesta- tional diabetes mellitus(GDM). Methods A total of 133 full- term pregnant women who were admitted in our hospital for de- livery were divided into three groups based on oral glucose tolerance test(OGTT) results:GDM group(n=49), gestational im- paired glucose tolerance(GIGT) group(n=39),and normal control group(n=45). The insulin secretion index(HOMA - IS), secretion resistance indext(HOMA-IR),and β cell function indext(HOMA-β) were calculated and compared. Re- sults The insulin secretion features(△l60,△l60/△G60,and HOMA-β)in GDM group,GIGT group,and control group showed a trend of decline (P0.05), while HOMA-IR showed an increasing trend (P0.05). After management with diet- ary intervention and other measures, the GDM group and GIGT group showed no significant differences with control group in terms of macrosomia, polyhydramnios,Cesarean section, and 1 -min and 5 -min Apgar scores. Conclusion Defects in both insulin secretion and insulin resistance contribute GDM. GIGT is an important stage of GDM. Monitoring and treatment should be strengt