妊娠期糖代谢异常患者胰岛素抵抗和胰岛β细胞功能的研究

Investigation of insulin resistance and isletβ-cell function in patients with abnormal glucose metabolism during pregnancy

目的探讨妊娠期糖代谢异常患者的胰岛素抵抗和胰岛β细胞功能的变化,以及对妊娠结局的影响。方法选取在我院就诊的171例孕妇检查资料,按照75g葡萄糖耐量试验(0GTT)结果分为妊娠期糖尿病组(GDM),妊娠期糖耐量受损组(GIGT),妊娠期空腹血糖受损组(GIFG)和正常对照组(NGT)。对各组的OGTT、胰岛素释放试验结果进行统计分析,计算出胰岛素抵抗指数(HOMA-IR),胰岛素分泌指数和胰岛素敏感指数,将结果进行比对分析。并对各组的妊娠结局进行分析。结果胰岛素抵抗指数(HOMA-IR)GDM组>GIFG组>GIGT组>对照组(P<0.05)。胰岛素分泌指数:GDM组<GIGT组<对照组和GIFG组(P<0.05)。经过治疗,GIGT和GIFG组的剖宫产率、早产率和新生儿Apgar评分和NGT组比较,差异无统计学意义。GDM组的并发症明显增加。结论妊娠期糖代谢异常患者均存在不同程度的胰岛素抵抗和胰岛β细胞功能缺陷,对妊娠期糖代谢异常患者应早诊断,早治疗,减少并发症的发生。

Objective ： To investigate the change of insulin resistance and islet β - cell function in patients with abnormal metabolism during pregnancy, as well as pregnancy outcome. Methods： To select the information of 171 cases of pregnant women in our hospital, in accordance with 75g glucose tolerance test （0GTT）, those women were divided into gestational diabetes mellitus （GDM） group, gestational impaired glucose tolerance group （GIGT）, gestational impaired fasting glucose group （GIFG） and normal control group （NGT）. The results of each group of OGTT and insulin release test were statistical analyzed and we calculated and analyzed the insulin resistance index （ HOMA - IR）, insulin secretion index and insulin sensitivity index of each group. And the pregnancy outcomes in each group were analyzed. Results ： To compare the Insulin resistance index （ HOMA - IR） of each group, GDM group 〉 GIFG group 〉 GIGT group 〉 control group （ P 〈 0. 05 ）. To compare the Insulin secretion index of each group, GDM group 〈 GIGT group 〈 control group and GIFG group （P 〈 0. 05 ）. After treatment, the complications of the group of GIGT and GIFG in the rate of cesarean section, preterm delivery rate and neonatal Apgar scores were no significant difference compared with group NGT. the complications of GDM group were Significant increased compared with group NGT. Conclusion ： There are varying degrees of insulin resistance and pancreatic β- cell dysfunction in patients with abnormal glucose metabolism during pregnancy, suggested that different patients with abnormal glucose metabolism should be early diagnosis, early treatment and reduce the incidence of complications.