产次对孕妇血糖水平和胰岛素抵抗的影响研究

Influence of parity on blood glucose levels and insulin resistance in pregnant women

目的探讨产次对孕妇血糖水平和胰岛素抵抗的影响。方法系统回顾性收集2015年1月—2016年12月符合入组条件的孕产妇临床资料,按照产次分为初次妊娠组(n=102)和再次妊娠组(n=106)。对比2组血糖、胰岛素水平及胰岛素抵抗指数,分析妊娠期糖尿病(GDM)发生情况。结果与初次妊娠组比较,再次妊娠组空腹血糖(FBG)、口服葡萄糖耐量试验1 h后血糖(OGTT-1h PBG)、口服葡萄糖耐量试验2 h后血糖(OGTT-2h PBG)均增高,差异有统计学意义(P<0.01)。与初次妊娠组相比,再次妊娠组的空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)也增高,差异有统计学意义(P<0.01);再次妊娠组GDM发生率高于初次妊娠组,差异有统计学意义(P<0.05)。结论相对于初次妊娠孕妇,再次妊娠孕妇血糖、胰岛素水平会增高,胰岛素抵抗发生风险会增加。

Objective To investigate the influence of parity on blood glucose levels and insulin resistance in pregnant women.Methods A retrospective study was conducted,208 pregnant women undergoing antenatal examination between January 2015 and December 2016 were divided into the first pregnancy group(n=102)and second pregnancy group(n=106).The blood glucose levels,fasting serum insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)and incidence of gestational diabetes mellitus(GDM)were compared between two groups.Results The levels of fasting blood glucose(FBG),oral glucose tolerance test 1h postprandial blood glucose(OGTT-1h PBG)and 2h postprandial blood glucose(OGTT-2h PBG)in the second pregnancy group were higher than those in the first pregnancy group(P<0.01).The FINS and HOMA-IR in the second pregnancy group were higher than those in the first pregnancy group(P<0.01).The incidence of GDM in the first pregnancy group was lower than that in the second pregnancy group(P<0.05).Conclusion Compared with women with first pregnancy,those with second pregnancy are more likely to have higher levels of blood glucose and serum insulin,as well as risk of GDM.