口服葡萄糖对正常孕妇和妊娠期糖尿病孕妇血清总胆汁酸水平的影响

Effect of oral administration of glucose on serum TBA levels in normal and GDM pregnant women

目的研究口服75 g葡萄糖对正常孕妇和妊娠期糖尿病(GDM)孕妇血清总胆汁酸(TBA)水平的影响。方法取本院门诊行糖耐量试验的非妊娠期肝内胆汁淤积症(ICP)孕妇,排除影响空腹血清总胆汁酸(TBA)的相关疾病后,分别收集到正常孕妇和GDM孕妇130例和64例,对其空腹、服糖后1 h、服糖后2 h血标本进行TBA检测,采用单因素重复测量设计方差分析分别比较两组3个时间点TBA、独立样本t检验比较两组孕妇同一时间点TBA。结果正常孕妇组各时间点TBA水平之间差异无统计学意义;GDM组孕妇空腹TBA与2 h TBA差异无统计学意义,1 h TBA与空腹TBA和2 h TBA比较差异均有统计学意义(P<0.01)。结论对于正常孕妇和GDM孕妇,当某些情况不适合空腹而又需要测定TBA时,两者可以分别考虑口服<75 g的葡萄糖1 h后和2 h后进行再TBA测定。

Objective To investigate the effect of oral administration of 75 g glucose on serum total bile acid（TBA） levels in both normal and gestational diabetes mellitus（GDM） pregnant women. Methods Non- ICP women outpatients who had underwent oral glucose tolerance test（OGTT） in the hospital excluding related diseases influencing serum TBA were involved in this investigation. Then serum specimens from 130 normal pregnant women and 64 GDM pregnant women were collected to detect TBA level at fasting blood glucose,1 h after OGTT and 2 h after OGTT,respectively. TBA levels at 3 different time points were compared between both groups by one- way repeated measurement ANOVA,while TBA levels at the same time point were compared between the two groups by independent samples t- test. Results In the normal pregnant women group,no significant difference was found among TBA levels at 3 time points,while in the GDM group,no significant difference was found between TBA levels on an empty stomach and 2 h after OGTT,but there were significant differences between TBA levels at 1 h after OGTT and on an empty stomach 2 h after OGTT（ P〈0. 01）. Conclusion For both normal and GDM pregnant women, when the TBA test is not allowed on an empty stomach but needed in some cases,it is suggested to test the TBA at 1 h or 2 h after oral administration of glucose less than 75 g.