妊娠期胰岛素抵抗及胰岛β细胞功能与体重指数、血脂水平、C反应蛋白的关系探讨

The relationship of insulin resistance and pancreatic β cell function with body mass index,lipid levels and C-reactive protein levels in pregnant women

目的探讨妊娠期胰岛素抵抗及胰岛β细胞功能与体重指数、血脂水平及C反应蛋白(CRP)的关系。方法 2007年7月至2008年5月在中山大学孙逸仙纪念医院门诊定期产检及分娩的孕产妇562例,于妊娠20～28周测定空腹血糖、胰岛素、血脂及CRP水平,分别对胰岛素抵抗及胰岛β细胞功能与孕前体重指数、血脂水平、CRP水平进行相关分析。结果 (1)妊娠期糖代谢异常孕妇胰岛素抵抗指数(HOMA-IR)、甘油三酯、CRP水平明显高于正常孕妇,高密度脂蛋白低于血糖正常组,差异有统计学意义(P<0.05)。(2)胰岛素抵抗与体重指数、甘油三酯、低密度脂蛋白及CRP存在正相关(P<0.05),而与胆固醇、高密度脂蛋白无明显相关性。控制变量体重指数后,胰岛素抵抗与总胆固醇、甘油三酯、低密度脂蛋白及CRP呈正相关(P<0.05),相关系数r分别为0.109、0.163、0.125及0.109。(3)胰岛β细胞功能与甘油三酯水平及CRP水平存在正相关(P<0.05),与体重指数、胆固醇、高密度脂蛋白、低密度脂蛋白水平无明显的相关性。控制变量体重指数后,胰岛β细胞功能只与CRP呈正相关(P<0.05),相关系数r为0.122。结论妊娠期糖尿病胰岛素抵抗程度增加;妊娠期胰岛素抵抗与体重指数、总胆固醇、甘油三酯、低密度脂蛋白及CRP呈正相关,而胰岛β细胞功能只与CRP存在正相关。

Objective To study the relationship of insulin resistance and pancreatic β cell function with body mass index,lipid levels,C-reactive protein levels respectively in pregnancy.Methods 562 pregnant women with regular antenatal care in Sun Yat-sen Memorial Hospital,Sun Yat-sen University from July 2007 to May 2008 were included in this study.Their height,weight,blood fasting glucose,fasting insulin,blood lipid and C-reactive protein were measured in 20th-28th pregnancy week,the relationships of insulin resistance and pancreatic β cell function with these indexes were studied respectively.Results(1)HOMA-IR,TG and C-reactive protein in the women with abnormal glucose metabolism were statistically higher(P<0.05),and HDL-C was lower(P<0.05),compared with the control group.(2) Insulin resistance was correlated with their body mass index,TG,LDL-C and C-reactive protein(P<0.05).There was no relationship between insulin resistance and TC or HDL-C.But,when the body mass index was adjusted,insulin resistance was correlated with TC,TG,LDL-C and C-reactive protein(P<0.05).Rank correlation coefficient was 0.109,0.163,0.125 and 0.109 respectively.(3) Pancreatic β cell function was correlated with TG and C-reactive protein rather than body mass index,TC,HDL-C or LDL-C.When the body mass index was adjusted,pancreatic β cell function was only correlated with C-reactive protein level(P<0.05),with rank correlation coefficient was 0.122.Conclusions The index of insulin resistance in gestational diabetes mellitus women is higher than that in normal pregnancy women.Insulin resistance is correlated with body mass index,TG,TC,LDL-C and C-reactive protein in pregnant women.Pancreatic β cell function is only correlates with C-reactive protein level.