妊娠期糖尿病胰岛素抵抗与铁蛋白和游离脂肪酸的相关性研究

Relationship of Insulin Resistance to Ferritin and Free Fatty Acid in Pregnant Women with Gestational Diabetes

目的探讨妊娠期糖尿病(GDM)孕妇胰岛素抵抗(IR)与铁蛋白(SF)和游离脂肪酸(FFA)的关系。方法 2011—2013年,按照随机原则选择在我院就诊的GDM孕妇71例为GDM组,正常孕妇50例为正常孕妇组,体检健康且未孕女性50例为正常非孕组。检测3组受试者血清SF、FFA、空腹血糖(FBG)及空腹胰岛素(Fins)水平,计算胰岛素抵抗指数(HOMA-IR)。结果正常非孕组、正常孕妇组及GDM组血清SF水平分别为(119.57±22.04)μg/L、(197.81±46.32)μg/L、(388.79±91.67)μg/L,差异有统计学意义(F=57.543,P<0.01);GDM组血清SF水平高于正常孕妇组和正常非孕组,正常孕妇组高于正常非孕组(P<0.01)。正常非孕组、正常孕妇组及GDM组血清FFA水平分别为(0.43±0.18)mmol/L、(0.67±0.14)mmol/L、(1.03±0.21)mmol/L,差异有统计学意义(F=37.619,P<0.01);GDM组血清FFA水平高于正常孕妇组和正常非孕组,正常孕妇组高于正常非孕组(P<0.01)。正常非孕组、正常孕妇组及GDM组HOMA-IR分别为(1.83±0.45)、(2.92±0.87)、(3.94±1.02),差异有统计学意义(F=45.071,P<0.01);GDM组HOMA-IR高于正常孕妇组和正常非孕组,正常孕妇组高于正常非孕组(P<0.01)。Pearson相关分析结果显示,血清SF水平(r=0.832)、血清FFA水平(r=0.759)均与HOMA-IR呈正相关(P<0.01);血清SF水平与血清FFA水平呈正相关(r=0.893,P<0.01)。结论 GDM孕妇存在IR及高铁蛋白血症、高游离脂肪酸血症,IR程度与血清SF、FFA水平相关,在GDM的早期干预中应重视SF和FFA的调控。

Objective To investigate relationship of insulin resistance（ IR） to ferritin（ SF） and free fatty acid （FFA）in pregnant women with gestational diabetes（GDM）. Methods Between 2011 and 2013,71 pregnant women with GDM（group A）,50 helthy pregnant women（group B）,50 heathy nonpregnant women（group C）were chosen in our hospi-tal. Serum levels of SF,FFA,fasting blood glucose（FBG）and fasting insulin（Fins）in the three groups were detected,and HOMA - IR calculated. Results Serum SF levels of groups A,B,C was（119. 57 ± 22. 04）μg/ L,（197. 81 ± 46. 32）μg/L,（388. 79 ± 91. 67）μg/ L respectively,and the difference was significantly different（F = 57. 543,P 〈 0. 01）;the serum SF levels of group A was significantly higher than those of groups B and C,group B higher than group C（P 〈 0. 05）. Serum FFA levels of groups A,B,C was（0. 43 ± 0. 18）mmol/ L,（0. 67 ± 0. 14）mmol/ L,（1. 03 ± 0. 21）mmol/ L respective-ly,and the difference was significantly different（ F = 37. 619,P 〈 0. 01）;the serum FFA level of group A was significantly higher than those of groups B and C,group B higher than group C（P 〈 0. 05）. HOMA - IR of groups A,B,C was（1. 83 ± 0. 45）,（2. 92 ± 0. 87）,（3. 94 ± 1. 02）respectively,and difference was significantly different（F = 45. 071,P 〈 0. 01）;the HOMA - IR of group A was significantly higher than those of groups B and C,group B higher than group C（P 〈 0. 05）. By Pearson correlation analysis,serum levels of SF and FFA were positively correlated with HOMA - IR（r = 0. 832,0. 759,P 〈0. 01）,and serum SF level was positively correlated with serum FFA level（ r = 0. 893,P 〈 0. 01）. Conclusion Pregnant women with GDM have IR,high levels of SF and FFA,and the degree of IR is correlated with serum levels of SF and FFA,so we should pay more attention to the control of SF and FFA in the early intervention of GDM.