妊娠糖尿病患者PAI-1与胰岛素抵抗相关性的初步探讨

Investigation on correlation between PAI-1 and Insulin rsistance in patients with gestational diabetes mellitus

目的:探讨妊娠糖尿病(GDM)患者血浆纤溶酶原激活物抑制剂-1(PAI-1)与胰岛素抵抗(IR)的关系。方法:选择31例妊娠糖尿病患者(GDM组)和35例糖耐量正常孕妇(NC组)作对照,分别测定PAI-1、空腹血糖(FPG)、空腹胰岛素(FIns)和糖化血红蛋白(HbAlc)水平,同时计算胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-HBCl),分析比较两组的差异与关系。结果:①GDM组的PAI-1、HOMA-IR、HOMA-HBCI分别为(60.84±27.81)ng/L、0.53±0.18、2.22±0.19;NC组分别为(36.85±11.61)ng/L、0.27±0.13、2.41±0.16,两组比较差异有统计学意义(P<0.01)。②相关性分析:血浆PAI-1分别与HOMA-IR、空腹胰岛素(FIns)、孕前BMI正相关,相关系数分别为:r=0.525,P=0.001;r=0.550,P=0.001;r=0.625,P=0.000。③多元逐步回归分析发现血浆PAI-1与HOMA-IR具有高度相关性。结论:GDM患者的血浆PAI-1水平明显升高与IR密切相关,PAI-1与GDM的发病有关。

Objective：To explore the correlation between Plasminogen activator inhibitor-l（PAI-l）and insulin resistance（IR） in patients with gestational diabetes mellitus（GDM）.Methods：The levels of PAI-I,FPG,Fins,HbA1c from 31 patients with GDM（GDM group） and 35 pregnant women with normal glucose tolerance（NC group） were detected.Homeostasis model insulin resistance index（HOMA-IR） was applied to assess the status of IR Insulin secretion by the homeostasis β-cell function index（HOMA-HBCI）.The difference in HOMA-IR,HOMA-HBCI,PAI-land other biochemistry indexes between the two groups were compared and analyzed.Results：①The levels of PAI-1,HOMA-IR and HOMA-HBCI were（60.84±27.81） ng/L,（0.53± 0.18）,（2.22±0.19） in GDM group and（36.85±11.61） ng/L,（0.27±0.13）,（2.41±0.16） in NC group,there was significant difference between two groups（P〈0.01）.②The level of PAI-1 was correlated with HOMA-IR（r=0.525,P=0.001） Fins（r=0.550,P=0.001）,BMI（r=0.625,P=0.000）.③A multiple linear stepwise regression analysis indicated that HOMA-IR was the important effect factors of PAI-1.Conclusion：The level of PAI-1 increase in women with GDM,which is related to IR and may participate in the pathogenesis of GDM.