胰岛素水平与孕期血糖的相关性研究

Study on relationship between insulin level and blood glucose during pregnancy

目的探讨胰岛素水平与孕期血糖的相关性。方法收集2019年1月至2020年10月上海市普陀区妇婴保健院产检的孕妇资料,根据75 g葡萄糖耐量试验(oral glucose tolerance text,OGTT)结果分为三组,对照组36例,血糖逆向增高组28例,妊娠期糖尿病组30例。比较3组血糖及其胰岛素结果,并对血糖-胰岛素相关性进行分析。结果糖尿病组FPG、1hr-FPG及2hr-FPG显著高于其他两组,差异有统计学意义。空腹胰岛素(Fins)3组差异无统计学意义。1hr-INS逆向增高组显著低于另外两组,2hr-INS糖尿病组显著高于其余两组,差异有统计学意义。HOMA-βF对照组显著高于逆向增高组和糖尿病组;MBCI逆向增高组显著高于其他两组,ISIΔI60/ΔG60显示糖尿病组胰岛分泌功能显著低于另外两组;HOMA-IR糖尿病组显著高于逆向增高组和对照组,差异均有统计学意义。对照组血糖值与胰岛素水平均呈中强度相关;逆向增高组服糖后1 h及2 h血糖与胰岛素均呈中度相关,空腹状态下血糖与胰岛素不相关;糖尿病组的空腹及服糖后2 h胰岛素水平与血糖值呈弱相关,但服糖后1h胰岛素水平与血糖值不相关。总体比较3组OGTT试验中血糖浓度及胰岛素分泌水平相关性为对照组(0.599)>逆向增高组(0.528)>糖尿病组(0.413)。结论妊娠期糖尿病患者主要表现为葡萄糖负荷的1 h内存在胰岛素分泌不足及胰岛素抵抗增强;孕期血糖逆向增高的孕妇主要表现为动静态胰岛素分泌相对不足,趋势与妊娠期糖尿病患者相似。

Objective To explore the relationship between insulin levels and blood glucose during pregnancy.Methods The data of pregnant women undergoing maternity examinations from 2019 to 2020 were collected and divided into three groups based on the 75 g OGTT results,36 cases in the control group,28 cases in the reverse hyperglycemia group,and 30 cases in the gestational diabetes group.Compare the blood glucose and insulin results of the three groups,and analyze the blood glucose-insulin correlation.Results The FPG,1 hr-FPG and 2 hr-FPG in the GDM group were significantly higher than the other two groups,and the difference was statistically significant.There was no statistically significant difference in Fins between the three groups.The 1 hr-INS Reverse elevation group was significantly lower than the other two groups,and the 2 hr-INS GDM group was significantly higher than the other two groups.The difference was statistically significant.The HOMA-βF control group was significantly higher than the reverse elevation group and GDM group;The MBCI Reverse elevation group was significantly higher than the other two groups,ISIΔI60/ΔG60 showed that the islet secretion function of the GDM group was significantly lower than the other two groups;The HOMA-IR GDM group was significantly higher than the Reverse elevation group And the control group,the difference is statistically significant.The blood glucose level of the control group was moderately correlated with insulin levels;The Reverse elevation group had a moderate correlation between blood glucose and insulin at 1 h and 2 h after taking glucose,while the blood glucose was not related to insulin in the fasting state;The insulin levels of the GDM group on fasting and 2 h after taking glucose It is weakly correlated with blood sugar level,but insulin level 1 h after taking sugar is not correlated with blood sugar level.The overall comparison between the blood glucose concentration and insulin secretion level in the 3 groups of OGTT test was the control group(0.599)>Reverse elevation group(0.528)>GDM group(0.413).Conclusion Patients with gestational diabetes mellitus mainly manifested as insufficient insulin secretion and increased insulin resistance within 1 hour of the glucose load.Patients with a reverse increase in blood glucose during pregnancy have insufficient basal insulin secretion and relatively insufficient dynamic insulin secretion.The trend is similar to that of patients with gestational diabetes.