游离脂肪酸与妊娠期糖尿病胰岛素抵抗的关系

FFA GDM and the Relationship between Insulin Resistance

目的 探讨游离脂肪酸（FFA）与妊娠期糖尿病（GDM）患者胰岛素抵抗（IR）的关系.方法 2010年1月～2012年11月,以同期GDM组（67例）、正常孕妇组（40例）及正常非孕组（40例）为研究对象.酶联法检测空腹血清FFA水平,同时检测空腹血糖（FBG）、空腹胰岛素（Fins）水平,计算胰岛素抵抗指数（HOMA-IR）值,并进行统计学分析.结果 正常非孕组、正常孕妇组及GDM组血清FFA水平（0.41±0.15,0.65±0.12和0.97±0.19）mmol/L依次升高,且相差显著（F=21.904,P＜0.01）,且GDM组显著高于正常孕妇组（t=3.781,P＜0.01）;三组HOMA-IR值（0.77±0.29,1.04±0.45和2.94±0.96）依次升高,且相差显著（F=55.613,P＜0.01）,且GDM组显著高于正常孕妇组（t=12.048,P＜0.01）.GDM患者空腹血清FFA水平与HOMA-IR值呈显著正相关（r=0.709,P＜0.01）,其相关性良好.结论 GDM患者体内存在着高FFA血症及IR状态,FFA水平与IR相关,此为早期干预GDM的发生发展提供了理论依据.

Objective To discuss free fatty acid （FFA） with gestational diabetes mellitus （GDM） in patients with insulin resistance （IR） relationshi. Methods January 2010 to November 2012,the same period with GDM group （67 cases） and normal pregnant woman group （40 cases） and normal nonpregnant group （40 eases） as the research object detected fasting serum FFA levers by enzyme linked method while detected FBG and Fins level, calculated HOMA-IR value and the statistical analysis. Results Three groups of serum FFA levels （0.41±0.15,0.65±0.12,0.97±0. 19）mmol/L of normal nonpregnant women group,normal group and GDM group rised in turn,and had significant difference （F= 21. 904, P〈0. 01）, especially GDM group was significantly higher than normal pregnant woman group （t= 3. 781, P〈0.01）. Three groups of HOMA-IR value （0.77±0.29,1.04±0.45,2.94!0.96） rised in turn,and had significantly defferenee （F=55. 613,P〈0. 01）,especially GDM group was significantly higher than normal pregnant woman group （t= 12. 048, P〈0.01）. Patients with GDM fasting serum FFA level and HOMA-IR value had a significant positive correlation （r= 0. 709, P〈0.01）, the correlation good. Conclusion There are high in patients with GDM FFA acidosis and IR state,FFA level and IR related. It would provide a theoretical basis to the occurrence of early intervention.