妊娠期糖尿病妇女血清成纤维细胞生长因子19、21水平与胰岛素抵抗的相关性分析

Relationship between serum FGF-19,FGF-21 levels and insulin resistance in women with gestational diabetes mellitus

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)妇女空腹血清成纤维细胞生长因子(fibroblast growth factors,FGFs)19、21水平与胰岛素抵抗的相关性及影响血清FGF-19、FGF-21水平的主要因素。方法选取2015年9月至2016年4月在华北理工大学附属医院就诊的孕妇115例,根据其口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果正常与否分为GDM组55例和对照组60例。分别对其一般资料、空腹血清FGF-19、FGF-21、空腹血糖、空腹胰岛素水平、胰岛素抵抗指数(insulin resistance,HOMA-IR)、胰岛β细胞功能指数(islet beta cell function,HOMA-β)等相关指标进行分析。结果 GDM组空腹血糖、空腹胰岛素、HOMA-IR、FGF-21高于对照组,差异均有统计学意义(P<0.05),GDM组FGF-19水平、HOMA-β低于对照组,差异有统计学意义(P<0.05);血清FGF-19与孕前体质量指数、空腹血糖、空腹胰岛素、HOMA-IR、FGF-21呈负相关(P<0.05),与HOMA-β呈正相关(P<0.05),血清FGF-21与孕前体质量指数、空腹血糖、空腹胰岛素、HOMA-IR呈正相关(P<0.05),与HOMA-β、FGF-19呈负相关(P<0.05);多元逐步线性回归分析:空腹血糖、HOMA-IR、空腹胰岛素是影响血清FGF-19水平的主要因素,空腹血糖是影响血清FGF-21水平的主要因素。结论血清FGF-19、FGF-21水平与胰岛素抵抗、空腹血糖关系密切,可能在GDM的发生发展中起作用。

Objective To explore the relationship between fasting serum FGF - 19, FGF -21 levels and insulin resistance in women with gestational diabetes mellitus （GDM） and the main factors that affect the levels of serum FGF - 19 and FGF -21. Methods 115 pregnant women in the North China University of Science and Technology Affiliated Hospital from September 2015 to April 2016, according to the results of oral glucose tolerance test （OGTF） were divided into GDM group （ n = 55 ） and control group （ n = 60 ）. Analyzed relevant indicators such as general information, fasting serum FGF - 19, FGF - 21, fasting blood glucose, fasting insulin levels and insulin resistance（ HOMA -IR）, islet beta cell function （HOMA beta）. Results In GDM group, fasting blood glucose, fasting insulin, HOMA - IR and FGF -21 were higher than the control group. The differences were statistically significant （P 〈 0. 05 ） ; HOMA beta and FGF- 19 level of GDM group were lower than the normal control group, the differences were statistically significant （P 〈 0. 05） ; Serum FGF - 19 was negatively correlated with pregnancy Body Mass Index （BMI） , fasting blood glucose, fasting insulin, HOMA - IR and FGF - 21 （ P 〈 0. 05 ） , and positively correlated with HOMA beta （ P 〈 0. 05 ） ; Serum FGF - 21 was positively correlated with BMI before pregnancy, fasting blood glucose, fasting insulin, HOMA - IR （ P 〈 0. 05 ）, and negatively correlated with HOMA beta and FGF - 19 （P 〈 0. 05 ）. Multiple linear regression analysis showed that fasting blood glucose, HOMA - IR and fasting insulin were the main factors affecting serum FGF - 19 level, and fasting blood glucose was the main factor affecting serum FGF - 21 level. Conclusion Serum levels of FGF - 21 and FGF - 19 are closely related to insulin resistance and fasting glucose, which may play a role in the occurrence and development of GDM.