临产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 Parturient Women

目的调查临产孕妇胰岛素抵抗指数分布情况及其与总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38~41周的临产孕妇共190例,检测空腹血糖、糖化血红蛋白、胰岛素、C肽、总1型前胶原氨基端前肽、N端-骨钙素、β-胶原特殊序列水平。分析糖化血红蛋白、胰岛素抵抗指数等糖代谢标志物与各骨代谢标志物水平的相关性,同时根据糖化血红蛋白水平分为糖代谢异常组和糖代谢正常组进行分组比较。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0.558（P〈0.001）,0.448（P〈0.001）和0.488（P〈0.001）,均为正相关。糖代谢异常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0.664（P〈0.001）,0.641（P〈0.001）和0.593（P〈0.001）,均为中度正相关。结论临产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,此相关性在糖代谢异常孕妇中表现得更为明显。

Objective To investigate the relationship between insulin resistance index and the level of bone metabolism markers in parturient women. Methods A total of 190 parturient women（ from 37 to 41 weeks）was selected. Fasting blood glucose,hemoglobin A1 c,fasting insulin,fasting C peptide,total type 1procollagen amino terminal propeptide,N-terminal osteocalcin,β-Cross Laps level were measured. The correlation between insulin resistance index and the level of bone metabolic markers were analyzed. Results The correlation coefficients of insulin resistance index with total type 1 procollagen amino terminal propeptide,N-terminal osteocalcin and β-Cross Laps were 0. 558（ P〈 0. 001）,0. 448（ P〈 0. 001） and0. 488（ P〈 0. 001）,respectively. In glucose metabolism impaired group,the correlation coefficients of insulin resistance index with total type 1 procollagen amino terminal propeptide,N-terminal osteocalcin andβ-Cross Laps were 0. 664（ P〈 0. 001）,0. 641（ P〈 0. 001） and 0. 593（ P〈 0. 001）,respectively,which were all positively correlated. Conclusion Insulin resistance index has positive correlation with synthetic marker,bone conversion rate marker and bone decomposition marker in parturient women. This correlation appears to be more critical in parturient women with impaired glucose metabolism markers.