不同糖耐量孕妇血清FGF21水平与胰岛素功能关系

Relationship between serum FGF21 level and insulin function in pregnant woman with different glucose tolerance

目的分析妊娠期正常糖耐量(GNGT)、妊娠期糖耐量减低(GIGT)和妊娠期糖尿病(GDM)孕妇血清成纤维细胞生长因子21(FGF21)水平及其与胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β指数)和胰岛素敏感指数(Matsuda指数)的相关性。方法将2016年6月至2017年6月在四川省妇幼保健院行50g糖负荷试验阳性结果的孕24~28周孕妇220例作为研究对象,7d后接受75g口服葡萄糖耐量试验(OGTT);按照其试验结果,分为GNGT 45例为N组、GIGT 60例为I组和GDM 115例为D组。采用酶联免疫吸附法对三组血清FGF21的含量进行检测,记录其HOMA-IR、HOMA-β指数和Matsuda指数的水平,并通过Pearson相关性分析FGF21水平与HOMA-IR、HOMA-β指数和Matsuda指数的关系。结果血清FGF21的水平和HOMA-IR在D组中的水平均为最高,其次是I组,而在N组中的水平均为最低,差异均有统计学意义(F=19.59,P<0.05;F=12.95,P<0.05);HOMA-β指数和Matsuda指数在D组中均为最低,其次是I组,而在N组中均为最高,差异均有统计学意义(F=9.52,P<0.05;F=10.55,P<0.05)。FGF21与HOMA-IR呈现正相关关系(r=0.32,P=0.01),其与HOMA-β指数、Matsuda指数均呈现负相关关系(r=-0.28,P<0.05;r=-0.34,P<0.05)。结论随着糖代谢受损的进一步加重,孕妇血清FGF21的水平逐渐升高,并且其与HOMA-IR、HOMA-β指数和Matsuda指数均存在相关性,可能与GDM的发生、发展密切相关。

Objective To analyze the serum fibroblast growth factor 21（FGF21）levels in pregnant women with gestational normal glucose tolerance（GNGT）,with gestational impaired glucose tolerance（GIGT）and with gestational diabetes mellitus（GDM）and the correlation among FGF21,insulin resistance index（HOMA-IR）,pancreaticβ-cell function index（HOMA-βindex）and insulin sensitivity index（Matsuda index）.Methods Total 220 pregnant women with 24-28 gestational weeks who showed positive in 50 g glucose load test in Sichuan Maternal and Child Health Care Hospital were selected as research objects and accepted 75 g oral glucose tolerance test（OGTT）after 7 days.According to the test results,they were divided into group N（45 cases with GNGT）,group I（60 cases with GIGT）and group D（115 cases with GDM）.The contents of serum FGF21 in three groups were detected by enzyme-linked immunosorbent assay（ELISA）.The levels of HOMA-IR,HOMA-βindex and Matsuda index were recorded,and the relationships between FGF21 level and HOMA-IR,HOMA-βand Matsuda index were analyzed by Pearson correlation analysis.Results The levels of serum FGF21 and HOMA-IR were the highest in group D,followed by group I,while in group N both of the two levels were the lowest,which showed that the differences were statistically significant（F=19.59,P0.05;F=12.95,P0.05）.The HOMA-βindex and Matsuda index were the lowest in group D,followed by group I,while in group N they were the highest,which showed that the differences were statistically significant（F=9.52,P0.05;F=10.55,P0.05）.FGF21 was positively correlated with HOMA-IR（r=0.32,P=0.01）but negatively correlated with HOMA-βindex and Matsuda index（r=-0.28,P0.05;r=-0.34,P0.05）.Conclusion With the further increase of impaired glucose metabolism,the levels of serum FGF21 in pregnant women increase gradually,and they are correlated with HOMA-IR,HOMA-βand Matsuda index,which may be closely related to the occurrence and development of GDM.