孕妇糖耐量状态与胰岛素抵抗、胰岛β细胞功能情况及妊娠结局分析

Analysis of the relationship between insulin resistance, cell function and pregnancy outcome of pregnant women with different glucose tolerance

目的:研究探讨孕妇不同糖耐量状态下胰岛素抵抗和胰岛细胞功能情况及对妊娠结局的影响。方法:选择2014年10月-2016年10月在本院产前检查及待产孕妇145例为研究对象,根据糖耐量试验结果分为妊娠期期糖尿病(糖尿病组46例)、妊娠糖耐量减低(糖耐量减低组50例)、结果正常者(正常组49例),比较各组孕妇胰岛素抵抗和分泌功能情况以及妊娠结局。结果:胰岛素抵抗程度(HOMA-IR)糖尿病组最高,糖耐量减低组次之,正常组最低(P<0.05);胰岛素分泌功能(HOMA-β)糖尿病组最低,糖耐量减低组次之,正常组最高(P<0.05)。胰岛素增量(AIR3-10)、胰岛素分泌曲线下面积(AUC-I、AUC-II)糖尿病组最低,糖耐量减低组次之,正常组最高(P<0.05)。3组孕妇妊娠结局无统计学差异(P>0.05)。结论:与正常糖耐量孕妇相比,有妊娠糖尿病以及糖耐量减低孕妇存在胰岛素抵抗且有细胞功能受损,提示孕妇该指标的异常应引起重视并加以规范治疗。

Objective： To investigate the insulin resistance and function of islet β-cell of pregnant women with different glucose tolerance status, and to study their influence on pregnancy outcomes, Methods： From October 2014 to October 2016, 145 pregnant women who came to hospital for antenatal examination or expectant delivery were recruited in the study. According to the results of the glucose tolerance test, the included pregnant women were divided into gestational diabetes mellitus （GDM） group （46 women）, gestational impaired glucose tolerance （GIGT） group （50 women）,and normal group （49 women）. The insulin resistance（IR）, insulin secretion oft3 cell and the pregnancy outcome were compared among the three groups. Results： IR of women in GDM group was significant highest （P 〈0.05） and IR of women in the normal group was significant lowest （P〈0.05）. Insulin secretion of β cell of women in GDM group was significant lowest and insulin secretion of β cell of women in normal group was significant highest （P〈0.05）. AIR3-10, AUC-I and AUC-II of women in GDM group was lowest, and AIR3-10, AUC-I and AUC-II of women in GIGT group were lower than those of women in normal group （P〈0.05）.There was no significant difference in pregnancy outcomes of pregnant women among the three groups （P〉0.05）. Conclusion.. Compared to pregnant women with normal glucose tolerance, pregnant woman with GDM or GIGT not only has insulin resistance, but also has impaired β-cell function. Pregnant woman with abnormal insulin resistance and impaired β-cell function should be paid more attention to, and should given regulate treatment.