中晚期孕妇两种胰岛β细胞功能指数与骨代谢标志物水平的相关性

Correlation Between Basal and Sugar-loaded Pancreatic Beta-cells Functional Index and Bone Metabolic Markers in the Late Second Trimester of Pregnancy

目的调查中孕晚期孕妇静态和动态胰岛β细胞功能指数与总1型前胶原氨基端前肽等骨代谢标志物水平的相关性。方法纳入孕期为24-26周孕妇共135例,检测空腹及餐后血糖、空腹胰岛素、空腹C肽、总I型前胶原氨基端前肽、N端-骨钙素、β-胶原特殊序列水平。计算并比较两种胰岛β细胞功能指数与各骨代谢标志物水平的相关性,同时根据有无妊娠糖尿病进行分组比较。结果静态胰岛β细胞功能指数与总1型前胶原氨基端前肽、N端-骨钙素和β-胶原特殊序列的相关性均无统计学意义（P〉0.05）。动态胰岛β细胞功能指数与总1型前胶原氨基端前肽和β-胶原特殊序列的相关系数分别为-0.242（P=0.005）和-0.277（P=0.001）,均为弱负相关。妊娠糖尿病组动态胰岛β细胞功能指数与总1型前胶原氨基端前肽、N端-骨钙素的相关系数分别为-0.418（P=0.002）、-0.365（P=0.008）,为低度负相关;与β-胶原特殊序列的相关系数为-0.560（P〈0.001）,为显著负相关。结论中孕晚期孕妇的动态胰岛β细胞功能指数与骨合成代谢、骨分解代谢的相关标志物存在负相关性,且此相关性在妊娠糖尿病患者群体中表现得更为明显。

Objective To investigate the relationship between two pancreatic beta-cells functional index and bone metabolism markers in the late second trimester of pregnancy.Methods We selected 135 women at 24 to26 week pregnant.Fasting and postprandial blood glucose,fasting insulin,fasting C peptide,total type 1procollagen amino terminal propeptide,N-terminal osteocalcin,beta-Cross Laps level were measured.The correlation between pancreatic beta-cells functional index and the level of bone metabolic markers were compared.Results There was no correlation between basal pancreatic beta-cells functional index and all three bone metabolic markers.The correlation coefficient of sugar-loaded pancreatic beta-cells functional index with total type 1 procollagen amino terminal propeptide and beta-Crosslaps was-0.242（P = 0.005） and-0.277（P = 0.001）,respectively.In gestational diabetes mellitus group,the correlation coefficient of sugarloaded pancreatic beta-cells functional index with total type 1 procollagen amino terminal propeptide,N-terminal osteocalcin and beta-Crosslaps was-0.418（P = 0.002） 、-0.365（P = 0.008） and-0.560（P 0.001,respectively,which were all negatively correlated.Conclusion Sugar-loaded pancreatic beta-cells functional index has negative correlation with bone metabolic markers in the late second trimester of pregnancy.The correlation between them is more obvious in pregnant women with gestational diabetes mellitus.