醛固酮与妊娠糖尿病的相关性研究

Correlation Between Aldosterone and Gestational Diabetes Mellitus

目的探讨妊娠时醛固酮变化与妊娠糖尿病(GDM)的关系。方法依试验结果随机筛选出妊娠糖尿病(GDM)组、妊娠糖耐量正常(NGT)组和对照组,各20例。计算孕前体质量指数(BMI);糖耐量试验时同时检测空腹血糖(FBG)、血脂、空腹胰岛素(Fins)、计算HOMA-IR指数,测定立位肾素-血管紧张素-醛固酮(RASS),记录肾素活性(PRA)、血管紧张素Ⅱ(ATⅡ)、醛固酮(ALD)。结果 GDM组醛固酮水平明显高于NGT组和对照组(pmol/L:1 130.15±135.45 vs 1 053.98±108.86 vs 544.31±127.97),醛固酮与FBG、1 h PBG、2 h PBG、Fins、HOMA-IR、TG呈正相关(r分别为0.658、0.701、0.652、0.757、0.713、0.429,P<0.05),与HDL-C呈负相关(r=-0.267,P=0.039)。多元逐步回归分析提示醛固酮为GDM的危险因素。结论妊娠时RASS系统的过度激活与GDM的发生有关。

Objective To analyze the relationship between plasma aldosterone level and gestational diabetes melli？tus. Methods All subjects were divided into three groups （n=20 in each group）：gestational diabetes mellitus （GDM） group, pregnancy with normal glucose group,non-pregnant healthy women group. Pre-pregnant body mass index （BMI） was calculated, and fasting blood glucose （FBG）, blood lipid level, Fins, HOMA-IR index, RASS, PRA, ATIi and ALD were examined besides glucose intolerance test. Results The plasma ALD level was significantly higher in GDM group than that of NGT group and control group（pmol/L：1 130.15±135.45 vs 1 053.98±108.86 vs 544.31±127.97）. The plasma ALD level was positively correlated with FBG,1 h PBG ,2 hPBG,Fins , HOMA-IR and blood triglyceride （r=0.657, 0.757, 0.713, 0.429,P〈0.05）,but negatively correlated with HDL-C（r=-0.267,P=0.039）. Stepwise regression analysis revealed that plasma aldo？sterone was the independent risk factor of GDM. Conclusion RASS is excessively activated in pregnancy, which contrib？utes to gestational diabetes mellitus.