妊娠期糖尿病孕妇生产前、后胰岛素抵抗及胰岛β细胞功能变化情况

Changes of insulin resistance and function of pancreatic islet β cells in pregnant women with gestational diabetes mellitus before and after delivery

目的探讨妊娠期糖尿病(GDM)孕妇生产前、后胰岛素抵抗(IR)及胰岛β细胞功能变化情况。方法选择在我院产检并分娩的42例GDM孕妇为观察组,同时期的正常孕妇42例为对照组。比较两组空腹血糖(FPG)、空腹胰岛素(FINS)水平、胰岛素抵抗程度及胰岛β细胞功能。结果产前,观察组FPG、FINS水平及HOMA-IR均高于对照组,HOMA-ISI、ΔI30/ΔG30及HOMA-β均低于对照组(P<0.05)。产后,观察组FPG、FINS水平及HOMA-IR明显降低,HOMA-ISI、ΔI30/ΔG30及HOMA-β明显升高(P<0.05);观察组HOMA-β低于对照组(P<0.05),两组上述其他指标无显著差异(P>0.05)。结论GDM孕妇在孕期存在明显的IR,产后6周恢复正常,但妊娠期胰岛β细胞功能下降,在其产后6周后未完全恢复。

Objective To investigate the changes of insulin resistance (IR) and function of pancreatic islet β cells in pregnant women with gestational diabetes mellitus (GDM) before and after delivery. Methods Forty-two GDM pregnant women examined and delivered in our hospital were selected as the observation group and 42 normal pregnant women as selected as the control group in the same period. The levels of fasting blood glucose (FPG), fasting insulin (FINS), degree of insulin resistance and function of pancreatic islet β cells were compared between the two groups. Results Before delivery, the levels of FPG and FINS and HOMA-IR in the observation group were higher than those in the control group. HOMA-ISI,ΔI30/ΔG30 and HOMA-β in the observation group were lower than those in the control group (P<0.05). After delivery, the levels of FPG and FINS and HOMA-IR in the observation group decreased significantly, while HOMA-ISI,ΔI30/ΔG30 and HOMA-β increased significantly (P<0.05);the HOMA-β of the observation group was lower than that of the control group (P<0.05);there were no significant differences between the two groups in the other indexes mentioned above (P>0.05). Conclusion GDM pregnant women had obvious IR during pregnancy and returned to normal at 6 weeks after post partum, but the function of pancreatic islet β cells decreased during pregnancy and did not fully recover at 6 weeks after delivery.