妊娠糖尿病合并胆石症与胰岛素抵抗的相关性研究

Correlation study of insulin resistance and cholelithiasis in patients with gestational diabetes mellitus

目的探讨妊娠糖尿病合并胆石症与胰岛素抵抗之间的相互关系。方法采用病例对照法,分别测定40例单纯妊娠糖尿病(A组)及40例妊娠糖尿病合并胆石症(B组)患者的空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),并计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI),观察各指标的变化及其相互关系。结果与A组比较,B组患者的FPG、FINS、TG、TC、LDL-C明显升高,ISI显著下降,HDL-C无显著性变化,存在更明显的胰岛素抵抗。ISI与TG、TC、LDL-C呈负相关,与HDL-C呈正相关,多元回归分析显示胆石症与ISI呈负相关,与HOMA-IR呈正相关。结论胰岛素抵抗可能是导致妊娠糖尿病形成胆石症的危险因素,积极改善妊娠糖尿病胰岛素抵抗的相关因素,可能成为预防妊娠糖尿病合并胆石症的一种方案。

Objective To study the correlation between the insulin resistancce and cholelithiasis in patients with gestational diabetes mellitus. Methods A case-match study was carried out,the fasting blood glucose （FPG）,fasting insulin （FINS）,total cholesterol （TC）,higher triglyceride（TG）,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL-C） were measured in 40 gestational diabetes mellitus with cholelithiasis （group A） and 40 without cholelithiasis （group B）,retrospectively.Insulin resistance （HOMA-IR） and insulin sensitivity index（ISI） were calculated. The changes of the indicators were observed and their correlation were analyzed. Results Compared with group A,the FBG,FINS,TG,TC,LDL-C were significantly increased and ISI was decreased,HDL-C was no significantly changed and there was significantly insulin resistance in group B.ISI was negatively correlated with TG,TC and LDL-C,and positively with HDL-C.Multiple regression analysis showed that there was negative correlation between cholelithiasis and ISI, and positively with HOMA-IR. Conclusion Insulin resistance might be a risk factor for gestational diabetes mellitus with cholelith.Actively improve the related factors of gestational diabetes mellitus insulin resistance,can be prevent gestational diabetes mellitus with cholelith.