胰岛素抵抗与早产的相关性研究

Relationship of Insulin Resistance with Premature Delivery

目的探讨胰岛素抵抗与早产的相关性。方法收集216例妊娠妇女,评估孕妇体重指数、血压、空腹血浆甘油三酯、总胆固醇、糖化血红蛋白、谷丙转氨酶、谷草转氨酶、尿素氮和肌酐水平。同时于妊娠24～28周时行OGTT试验,采用QUICKI评估胰岛素灵敏度检测指数。采用Pearson或Spearman秩相关分析QUICKI及其他实验室检测指标与早产发生率的相关性。结果①216例孕妇,其中有88例孕妇出现早产,128例孕妇为足月产,早产孕妇体重指数、血浆甘油三酯和总胆固醇水平高于足月产组(P<0.05);早产组孕妇糖化血红蛋白水平以及高血压百分率均稍高于足月产组,但差别无统计学意义;两组孕妇肝肾功能指标均无明显差别;②早产组孕妇空腹血糖以及OGTT试验后1 h、2 h、3 h血糖水平均高于足月产组,而QUICKI指标则低于足月产组(P<0.05),两组间各时间点血浆胰岛素水平无明显差别;③QUICKI与早产发生率呈负相关,相关系数r=-0.786(P=0.026),其余各指标与早产发生率无明显相关性。结论对于空腹血糖调节受损或糖耐量异常孕妇,进行OGTT试验,评估其QUICKI指标和胰岛素抵抗情况,可以在一定程度上预测孕妇早产的发生率。

Objective To investigate the relationship of insulin resistance with premature delivery.Methods Total 216 pregnant woman were enrolled and body mass index（BMI） and fasting serum levels of triglyceride（TG）,total cholesterol（TC）,GHBA1C,alanine aminotransferase（AST）,aspartase aminotransferase（ALT）,blood urea nitrogen（BUN） and creatinine（Cr） were evaluated.In the gestation period of 24-28 weeks OGTT was performed and QUICKI was used to evaluate the sensitivity of insulin.Pearson or Spearman rank correlation analysis was used to analyze the relationship of QUICK and other experimental indexes with the incidence of premature delivery.Results ①In all 216 pregnant women,88 cases were with premature delivery,128 with full term delivery.BMI,serum levels of TG and TC in the premature delivery group were significant higher than that in the full term delivery group（P0.05）,and GHBA1C and the rates of hypertension in premature group were slightly but insignificantly higher than that in full term delivery group,and there was no difference in liver and renal indexes between these two groups;②Fasting serum level and 1 h,2 h and 3 h post-OGTT levels of glucose were significantly higher in the premature group while QUICKI was lower as compared to those of the full term group（P0.05）.There was no difference in serum levels of insulin in the different time points;③QUIKCI was negative correlation with the incidence of premature delivery（r=-0.786,P=0.026） while there was no significant correlation of other indexes with the incidence of premature delivery.Conclusion The risk of premature delivery could be predicted by the evaluation of QUICK and insulin resistance via OGTT in pregnant women with impairment of fasting glucose or impairment of glucose tolerance.