GDM患者脂代谢与胰岛素抵抗的关系

Relationship between lipid metabolism and insulin resistance in patients with GDM

目的探讨妊娠期糖尿病(GDM)患者血清脂代谢与胰岛素抵抗的关系。方法选取2015年2月至2016年10月在该院治疗的GDM孕妇110例(GDM组),同时选取健康孕妇100例作为对照组,检测两组空腹血糖(FBG)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、磷酸酪氨酸衔接蛋白(APPL1)、脂肪细胞型脂肪酸结合蛋白(AFABP)。结果 GDM组HDL-C为(0.90±0.22)mmol/L,明显低于对照组[(1.41±0.50)mmol/L],差异有统计学意义(P<0.05),而TG、TC、LDL-C、APPL1和AFABP水平均明显高于对照组,差异有统计学意义(P<0.05);GDM组FBG、FINS和胰岛素抵抗指数(HOMA-IR)明显高于对照组,差异有统计学意义(P<0.05);GDM组HOMA-IR与TG、TC、LDL-C、APPL1和AFABP呈正相关(r=0.413、0.422、0.711、0.322和0.401,P<0.05),与HDL-C呈负相关(r=-0.304,P<0.05);对照组HOMA-IR与脂代谢指标无相关性(P>0.05)。结论 GDM孕妇胰岛素抵抗与脂代谢水平有关,临床治疗时应合理膳食,控制血糖血脂水平。

Objective To investigate the relationship between serum lipid metabolism and insulin resistance in patients with gestational diabetes mellitus(GDM).Methods A total of 110 pregnant women with GDM in our hospital were selected from February 2015 to October 2016(GDM group),and 100 healthy pregnant women were selected as control group,fasting blood glucose(FBG),fasting insulin(FINS),three glycerol(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),phosphotyrosine binding protein(APPL1)and adipocyte fatty acid binding protein(AFABP)of two groups were detected.Results HDL-C of GDM group was(0.90±0.22)mmol/L,which was significantly lower than that of the control group[(1.41±0.50)mmol/L](P<0.05).While TG,TC,LDL-C,APPL1 and AFABP of the GDM group were all significantly higher than the control group(P<0.05).The FBG,FINS and insulin resistance index(HOMA-IR)in the GDM group were significantly higher than those in the control group(P<0.05).HOMA-IR was positively correlated with TG,TC,LDL-C,APPL1 and AFABP in GDM group(r=0.413,0.422,0.711,0.322 and 0.401,P<0.05),which was negatively correlated with HDL-C(r=-0.304,P<0.05).There was no correlation between HOMA-IR and lipid metabolism in control group(P>0.05).Conclusion Insulin resistance is related to the level of lipid metabolism in pregnant women with GDM,the clinical treatment should take reasonable diet,as well as control blood glucose and lipid levels.