妊娠期葡萄糖筛查异常孕妇的PTP-1B与IR相关性的研究

The correlation of protein tyrosine phosphatase 1B and insulin resistance in pregnancy with abnormal glucose screening

目的探讨蛋白酪氨酸磷酸酶1B（PTP-1B）与胰岛素抵抗（IR）的关系及在妊娠期糖尿病（GDM）发病机制中的作用，以早期预防和干预GDM，减少母儿并发症。方法2011年4～10月在我院产前检查的妊娠期糖尿病孕妇（C组）、葡萄糖负荷试验（GCT）异常而葡萄糖耐量试验（OGTr）正常的孕妇（B组）及葡萄糖负荷试验正常的孕妇（A组）各30例，分别测定空腹PTP-1B、空腹血糖、空腹胰岛素水平，同时计算胰岛素抵抗指数（HOMA—IR）和胰岛B细胞功能指数（HOMA—HBCI），分析比较各组的差异与关系。结果①C组的HOMA—IR明显高于A组、B组，差异有统计学意义（P〈0．01，P〈0．05）。②C组的PTP-1B值明显高于A组、B组，差异有统计学意义（P〈0．01）。③相关性分析：血浆PTP-1B与孕前BMI、空腹血糖、空腹胰岛素、HOMA—IR呈正相关．相关系数分别为：r=0．347，P=0．001；r=0．263，P=0．012；r=0．287，P=0．006；r=0．318，P=0．002。结论GDM存在更严重的IR，PTP-1B与IR有关，可能参与GDM的发生和发展。

Objective To explore the correlation of protein tyrosine phosphatase 1B and insulin resistance in the pregnancy with abnormal glucose screening result and its role in the pathogenetic course of gestational diabetes mellitus. So we can prevent and treat this disease as early as we can in order to prevent the complications of the mother and ihe fetal. Methods From April of 2011 to October of 2011 ,we recruited 90 singleton pregnancy in the study. 30 with gestational diabetes mellitus was group C, 30 that glucose challenge test was abnormal group B, 30 that glucose challege test was normal group B. Fast Protein Tyrosine Phosphatase 1B, glucose and insulin of the 90 singleton pregnancy were measured. Then we calculated the index of insulin resistance and pancreatic beta-cell function （HOMA-IR, HOMA-HBCI） and analyzed the significant difference in the 3 groups. Results The HOMA-1R in group C was significantly increasing than that in A and B （P 〈 0.01 ,P 〈 0.05）. Protein tyrosine phosphatase 1B in group C was significantly increasing than that in A and B （P 〈 0.01 ）. There were positive correlation between protein tyrosine phosphatase 1B and BMI,fast glucose, fast insulin and HOMA-IR （r = 0.347,P = 0.001 ;r = 0.263,P = 0.012;r = 0.287, P = 0.006 ;r =0.318 ,P = 0.002）. Conclusion The insulin resistance in gestational diabetes mellitus is more serious . There is positive correlation between protein tyrosine phosphatase 1B and insulin resistance. These may take some roles in the pathogenetic course of gestational diabetes mellitus.