妊娠期糖尿病患者脐血FGF19水平与胰岛素抵抗及新生儿出生体重的关系

The Relationship Between Cord Blood FGF19 Level and Insulin Resistance and Birth Weight in Patients with Gestational Diabetes

目的探讨妊娠期糖尿病(GDM)患者脐血成纤维细胞因子19(FGF19)浓度的变化与胎儿胰岛素抵抗(IR)、出生时体重的相关性。方法选择2017年2月~2018年11月于遂宁市中心医院住院分娩的GDM患者44例为病例组,正常妊娠期妇女44例为对照组,分别测定两组脐血FGF19、血糖胰岛素水平,计算胰岛素抵抗指数(HOMA-IR),测量新生儿的身长、体重,并分析脐血FGF19与以上指标的相关性。结果病例组脐血FGF19水平低于对照组,胰岛素、HOMA-IR、新生儿体重高于对照组(P<0.05),病例组脐血FGF19水平与血糖、胰岛素、HOMA-IR及新生儿体重呈负相关(r=-0.583、-0.892、-0.804、-0.513,P<0.05)。胰岛素、HOMA-IR是FGF19降低的独立危险因素(P<0.05)。结论GDM患者脐血中FGF19水平明显降低,与胰岛素抵抗、新生儿体重相关。脐血FGF19的变化可作为预测新生儿出生时体重及健康的指标。

Objective To investigate the relationship between the change of cord blood fibroblast factor 19(FGF19)concentration and fetal insulin resistance(IR)and birth weight in patients with gestational diabetes(GDM).Methods 44 cases of GDM patients who were hospitalized in Suining Central Hospital from February 2017 to November 2018 were selected as the case group,and 44 cases of normal pregnancy women were selected as the control group.The two groups of cord blood FGF19,blood glucose insulin levels were measured respectively,the insulin resistance index(HOMA-IR)was calculated,the length and weight of the newborn were measured,and the correlation between cord blood FGF19 and the above indicators was analyzed.Results The cord blood FGF19 level of the case group was lower than that of the control group,and the insulin,HOMA-IR,and neonatal weight were higher than that of the control group(P<0.05).The cord blood FGF19 level in the case group was negatively correlated with blood glucose,insulin,HOMA-IR and newborn weight(r=-0.583,-0.892,-0.804,-0.513,P<0.05).Insulin and HOMA-IR were independent risk factors for FGF19 reduction(P<0.05).Conclusion The level of FGF19 in the cord blood of patients with GDM is significantly reduced,which is related to insulin resistance and neonatal weight.The change of cord blood FGF19 can be used as an index to predict the birth weight and health of newborns.