中孕晚期孕妇胰岛素抵抗指数与骨代谢标志物水平的相关性

Correlation Between Insulin Resistance Index and Bone Metabolic Markers in the Late Second Trimester of Pregnancy

目的 调查中孕晚期孕妇胰岛素抵抗指数分布及其与总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 纳入孕周为24～26周孕妇共154例,检测空腹血糖、空腹胰岛素、空腹C肽、总Ⅰ型胶原氨基端延长肽、N端-骨钙素、β-胶原特殊序列水平.比较胰岛素抵抗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 胰岛素抵抗指数与总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系数分别为0.469（P＜0.001）,0.201（P=0.012）和0.337（P ＜0.001）,均为正相关.妊娠糖尿病组孕妇胰岛素抵抗指数与总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系数分别为0.623（P ＜0.001）,0.535（P ＜0.001）和0.718（P ＜0.001）,均为强正相关.结论 中孕晚期孕妇的胰岛素抵抗指数与骨合成代谢、骨转换率和骨分解代谢的相关标志物存在正相关,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 insulin resistance index and the level of bone metabolism markers in the late the second trimester of pregnancy. Methods Pregnant women in late second trimester of pregnancy （from 24 to 26 weeks） were selected. Fasting blood glucose, fasting insulin, fasting C peptide, total type 1 procollagen amino terminal propeptide, N-terminal osteocalcin, beta-CrossLaps level were measured. The correlation between insulin resistance index and the level of bone metabolic markers was compared. Results The correlation coefficient of insulin resistance index with total type 1 procollagen amino terminal propeptide, N-terminal osteocalcin and beta-CrossLaps was 0. 469 （ P 〈 0. 001 ）, 0. 201 （ P = 0.012） and 0. 337 （P 〈 0. 001 ）, respectively. In gestational diabetes mellitus group, the correlation coefficient of insulin resistance index with total type 1 procollagen amino terminal propeptide, N-terminal osteocalcin and beta-CrossLaps was 0. 623 （P 〈 0. 001 ）, 0. 535 （ P 〈 0. 001 ） and 0. 718 （ P 〈 0. 001 ）, respectively, which were all strongly and positively correlated. Conclusion Insulin resistance index has positive correlation with synthetic marker, bone conversion rate marker and bone decomposition marker and metabolism markers in the late second trimester of pregnancy. The correlation in pregnant women with gestational diabetes mellitus is more obvious.