BCAAs和3-HIB与妊娠期糖尿病向2型糖尿病转变者胰岛素抵抗的关系

Relationship between the levels of BCAAs and 3-HIB of women with the progression from gestational diabetes mellitus to type 2 diabetes and their insulin resistance

目的:探究支链氨基酸(BCAAs)、3-羟基异丁酸(3-HIB)与妊娠期糖尿病(GDM)向2型糖尿病(T2DM)转变的胰岛素抵抗(IR)关系。方法:前瞻性选择2013年10月—2014年10月本院收治的GDM患者103例为病例组,随访产后5年,根据GDM患者是否进展为T2DM分为未进展组(n=57)和进展组(n=46),同期产前检查正常妊娠60例为对照组,比较各组血清BCAAs、3-HIB水平,采用Pearson相关分析T2DM患者血清BCAAs、3-HIB水平与IR的相关性,采用多因素logistic回归分析GDM进展为T2DM的影响因素。结果:病例组血清BCAAs(56.77±6.11μmol/L)、3-HIB(0.05±0.03 mmol/L)水平高于对照组(52.20±5.32μmol/L、0.02±0.01 mmol/L),进展组(58.69±6.97μmol/L、0.07±0.03 mmol/L)高于未进展组(58.69±6.97μmol/L、0.04±0.02 mmol/L)(均P<0.05);T2DM患者血清BCAAs、3-HIB水平与IR均呈正相关,且血清BCAAs、3-HIB高水平是GDM进展为T2DM的危险因素(均P<0.05)。结论:BCAAs、3-HIB水平在妊娠期糖尿病向2型糖尿病转变过程中逐渐上升,并与该过程中胰岛素抵抗相关。

Objective:To investigate the relationship between the levels of branched-chain amino acids(BCAAs)and 3-hyrxyibutyrate(3-HIB)of women with the progression from gestational diabetes mellitus(GDM)to type 2 diabetes mellitus(T2DM)and their insulin resistance(IR).Methods:103 pregnant women with GDM(in study group)and 60 healthy pregnant women(in control group)were selected prospectively in the study from October 2013 to October 2014.The women in the study group were further divided into group A and group B according to the absence or presence of T2DM when followed up to 5 years after delivery.57 women without T2DM were in group A and 46 women with T2DM were in group B.Serum BCAAs and 3-HIB levels of women were compared among these groups.Pearson correlation was used to analyze the correlation between serum BCAAs and 3-HIB levels of women with T2DM and their IR,and multivariate Logistic regression was used to analyze the influencing factors of women from GDM to T2DM.Results:The serum levels of BCAAs and 3-HIb of women in the study group were 56.77±6.11 mol/L and 0.05±0.03 mmol/L,which were significant higher than those(52.20±5.32 mol/L and 0.02±0.03mmol/L)of women in the control group(all P<0.05).The serum levels of BCAAs and 3-HIb of women in group B were 58.69±6.97 mol/L and 0.07±0.03mmol/L,which were significant higher than those(58.69±6.97 mol/L,0.04±0.02mmol/L)of women in group A(all P<0.05).Serum BCAAs and 3-HIb levels of women with T2DM were positively correlated with their IR,and high serum BCAAs and 3-HIb levels were risk factors of women with the progression from GDM to T2DM(all P<0.05).Conclusion:The levels of BCAAs and 3-HIB of women with the progression from GDM to T2DM have increased gradually,which are associated with their insulin resistance during the progression from GDM to T2DM.