妊娠期糖耐量异常患者孕中期胰岛素抵抗及胰岛β细胞功能状态的探讨

Study of Insulin Resistance and the Capacity of Pancreatic β-cell in Women with Abnormal Glucose Tolerance during the Second Trimester of Pregnancy

目的:探讨孕中期糖耐量异常妇女胰岛素抵抗及胰岛β细胞功能状态。方法:分别用葡萄糖氧化酶法、化学发光法测定糖耐量异常孕妇31例(Ⅱ组)和糖耐量正常孕妇35例(Ⅰ组)75gOGTT中各时点血糖、胰岛素和C肽水平;用胰岛素敏感指数(ISI)和空腹胰岛素分泌指数(FBCI)来分析胰岛素抵抗和胰岛β细胞功能状态。结果:①糖耐量异常组(Ⅱ组)的空腹血糖、空腹胰岛素、C肽水平均明显高于糖耐量正常组(Ⅰ组)(P<0.01)。②Ⅱ组ISI、FBCI均显著高于Ⅰ组(P<0.01)。③Ⅰ组胰岛素、C肽分泌高峰在服糖后1小时,而Ⅱ组则延迟至服糖后2小时。结论:糖耐量异常孕妇于孕中期即存在较正常妊娠妇女更为明显的胰岛素抵抗,且胰岛β细胞功能已有下降。

Objective：To approach the state of insulin resistance and the function of islet β-cell in pregnant women with abnormal glucose tolerance during the second trimester of pregnancy. Methods： Blood glucose concentration was measured by glucose oxidase method in thirty-one pregnant women with abnormal glucose tolerance （group Ⅱ ） and thirty-five women with normal glucose tolerance （ group Ⅰ ）. Plasma insulin and C-peptide were determined by nsulin sensitivity index （ISI） and fasting β-cell function index （FBCI） were used to analyze the state of insulin resistance and the function of β-cell of islet. Results：（1）Fasting plasma glucose,insulin and C-peptide levels of group Ⅱ were significantly higher than that of group Ⅰ （ P〈 0.01 ） .（2）Both of ISI and FBCI were higher in group Ⅱ, and there were significant difference between group Ⅱ and Ⅰ （ P 〈 0.01 ）. （3）The peak value of insulin and C-peptide was found at the first hour of post-oral glucose in group I,and at the second hour in group Ⅱ. Concluslons：There existed more insulin resistance in women with abnormal glucose tolerance than normal pregnant women during the second trimester pregnancy, when the function of islet islet should be defected.