妊娠期糖尿病孕妇及胎儿胰岛素与游离脂肪酸分析

Fetal and Maternal Levels of Insulin and Free Fatty Acid in Pregnant Women with Gestational Diabetes Mellitus

目的了解妊娠期糖尿病(GDM)孕妇及胎儿的胰岛素、血糖与血脂情况。方法选取我院定期产检并住院分娩的GDM孕妇,并经饮食控制至正常血糖水平的81例作为GDM组,对照组健康孕妇86例;以及对应的GDM母亲胎儿脐血65例及正常孕妇胎儿脐血47例。采用生化分析仪检测母血清及脐血的血糖、游离脂肪酸(NEFA)、总胆固醇(TC)和三酰甘油(TG)水平,电化学发光法检测母血清及脐血胰岛素。结果 (1)GDM孕妇与正常孕妇相比,血糖、TG、TC与NEFA间差异无统计学意义(P>0.05);但是胰岛素水平〔(25±15)mU/L比(15±8)mU/L〕差异有统计学意义(P<0.05)。(2)GDM孕妇胎儿和正常孕妇胎儿相比,脐血血糖、TG与TC水平差异无统计学意义(P>0.05),但NEFA〔(0.19±0.08)mmol/L比(0.15±0.05)mmol/L〕、胰岛素〔(15±13)mU/L比(8±4)mU/L〕水平差异有统计学意义(P<0.05)。结论经血糖控制的GDM孕妇,虽然血糖与血脂均正常,但仍存在高胰岛素血症;并且其胎儿的胰岛素与NEFA水平升高,这可能是GDM孕妇子代易发生糖尿病等代谢性疾病的重要因素。

Objective To explore the fetal and maternal levels of insulin, glucose and lipid in pregnant women with gestational diabetes mellitus （GDM）. Methods Eighty - one and 86 maternal blood samples, and 65 and 47 venous cord blood samples were collected from 81 well - controlled GDM mothers and 86 healthy mothers. The blood glucose, free fatty acids （ NEFA）, total cholesterol （ TC ）, and triglyceride （TG） levels of the blood samples were measured with automatic biochemical analyzer. The insulin levels were measured with method. Results The blood glucose, TG, TC, and NEFA were not significantly different between the well - controlled GDM mothers and the healthy mothers （P 〉 0. 05 ）, but the insulin level of the GDM group was higher than that of the healthy group [ （25 ± 15 ） mU/L vs. （ 15 ± 8） mU/L; P 〈 0. 05 5. The fetal levels of blood glucose, TG, and TC were not significantly different between the two groups （P 〉 0. 05）, but the GDM group had higher fetal NEFA and insulin levels [ （0. 19 ±0. 08） mmol/L vs. （0. 15 ±0. 05） retool/L, （ 15 ±13） mU/L vs. （8 ：1： 4） mU/L; P 〈 0. 05 ]. Conclusion Well- controlled GDM pregnant women may have normal blood glucose and lipid, but still have hyperinsulinemia. The fetal insulin and NEFA are still higher, which may be one of the causes of metabolic diseases （eg. diabetes mellitus） in the filial generation.