妊娠期糖尿病患者血清中胰高血糖素样肽-1及二肽基肽酶-IV的浓度检测及临床意义

The level and clinical significance of glucagon like peptide-1 and dipeptidyl peptidase-IV in gestational diabetes mellitus

目的:研究妊娠期糖尿病(GDM)患者血清中胰高血糖素样肽-1(GLP-1)和二肽基肽酶-IV(DPP-IV)的水平,并探讨其在妊娠期糖尿病中的作用。方法:采用ELISA法检测43例GDM患者、38例糖耐量正常孕妇及35例正常非孕妇血清GLP-1及DPP-IV的水平;同时测定3组妇女空腹血糖(FPG)、胰岛素(FINS)及糖化血红蛋白(HbA1c)的水平,并根据HOMA稳态模型提出的公式,计算胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-HBCI)进一步评价胰岛β细胞的功能。结果:①GDM患者血清GLP-1水平明显低于糖耐量正常孕妇组及正常非孕妇组,差异有统计学意义(P<0.05),血清DPP-IV水平明显高于糖耐量正常孕妇组及正常非孕妇组,差异有统计学意义(P<0.05);②GDM患者与另两组相比,存在明显的胰岛素抵抗(HOMA-IR明显增大,P<0.05),而胰岛素分泌明显下降(HOMA-HBCI明显减小,P<0.05),差异均有统计学意义。结论:GDM患者血清GLP-1水平明显下降,而DPP-IV水平明显升高,可能在GDM的发病中发挥一定的作用。

Objective：To investigate the serum levels of glucagon like peptide-1（GLP-1） and dipeptidyl peptidase-IV（DPP-IV） in gestational diabetes mellitus（GDM）,and discuss the role of them in GDM. Methods：The serum levels of GLP-1 and DPP-IV in 43 GDM,38 pregnant women with normal glucose tolerance and 35 normal non-pregnant women were determined by ELISA,and fasting plasma glucose（FPG）,insulin,glycosylated hemoglobin A1c（HbA1c） were also measured simultaneously,moreover,according to the HOMA stable state model,the insulin resistance index（HOMA-IR） and insulin secretion index（HOMA-HBCI） were calculated to further appraise the function of beta cell. Results：① Significantly reduced serum GLP-1 concentration and elevated serum DPP-IV concentration were found in the women with GDM as compared with normal glucose tolerance group and normal non-pregnant women group（P0.05）.② Compared with the other two groups,obviously insulin resistance and insulin secretion decrease were discovered in GDM women. Conclusion：The secretion defect of GLP-1 and hypersecretion of DPP-IV may play a great part in the pathogenesis of gestational diabetes mellitus.