妊娠期糖尿病患者铁代谢和激素及胰岛素抵抗的相关性分析

Correlation analysis of iron metabolism,hormone and insulin resistance in gestational diabetes women

目的探讨妊娠期糖尿病患者铁代谢和激素、胰岛素抵抗的相关性。方法选取2018年7月至2020年10月信阳市人民医院收治的78例妊娠期糖尿病患者为观察组,另外选取同期于本院进行体检的78例健康体检孕妇作为对照组。检测并比较两组孕妇的铁代谢指标、应激激素水平以及胰岛素抵抗性,分析三者之间的相关关系。结果两组孕妇的皮质醇水平无显著差异,数据比较无统计学意义(P>0.05)。观察组孕妇的肾上腺素(477.54±125.03)ng/L以及去甲肾上腺素(201.39±72.41)ng/L显著高于对照组,数据具有统计学意义(P<0.05)。两组孕妇的血红蛋白水平无显著差异,数据比较无统计学意义(P>0.05)。观察组孕妇的血清铁(14.36±4.28)μmol/L、血清铁蛋白(177.26±35.47)μg/L、转铁蛋白饱和度(0.37±0.12)%、胰岛素抵抗指数(2.56±0.73)显著高于对照组,数据具有统计学意义(P<0.05)。观察组孕妇的肾上腺素、去甲肾上腺素以及皮质醇水平与血清铁蛋白呈正相关关系(P<0.05)。观察组的肾上腺素和皮质醇水平与转铁蛋白饱和度呈正相关关系(P<0.05)。两组孕妇的胰岛素抵抗指数与血清铁蛋白、转铁蛋白饱和度均呈正相关关系(P<0.05)。结论高水平血清铁蛋白和铁转蛋白饱和度与妊娠期糖尿病的发生具有密切相关性,过度铁负荷在妊娠期糖尿病孕妇的胰岛素抵抗和应激适应障碍发生的过程中具有重要促进作用,有助于临床医务人员对早期妊娠期糖尿病进行筛查并采取相应治疗措施。

Objective To explore the relationship between iron metabolism and hormones and insulin resistance in women with gestational diabetes.Methods Totally 78 patients with gestational diabetes who were treated in our hospital from July 2018 to July 2020 were enrolled in the observation group.78 healthy pregnant women who underwent physical examination at the same time were selected as the control group.The iron metabolism index,stress hormone level and insulin resistance of the two groups of pregnant women were detected and compared,and the correlation between the three was analyzed.Results There were no significant differences in cortisol levels between the two groups,and the data were not statistically significant(P>0.05).The adrenaline(477.54±125.03)ng/L and norepinephrine(201.39±72.41)ng/L in the observation group were significantly higher than those in the control group,and the data were statistically significant(P<0.05).There was no significant difference in hemoglobin levels between the two groups of pregnant women,and the data were not statistically significant(P>0.05).Serum iron(14.36±4.28)μmol/L,serum ferritin(177.26±35.47)μg/L,transferrin saturation(0.37±0.12)%,and insulin resistance index(2.56±0.73)were significantly higher in the observation group.The data in the control group were statistically significant(P<0.05).The levels of adrenaline,norepinephrine and cortisol in the observation group were positively correlated with serum ferritin(P<0.05).The levels of adrenaline and cortisol in the observation group were positively correlated with the transferrin saturation(P<0.05).The insulin resistance index of the two groups of pregnant women was positively correlated with serum ferritin and transferrin saturation(P<0.05).Conclusion High levels of serum ferritin and iron transprotein saturation are closely related to the occurrence of gestational diabetes.Excessive iron load plays an important role in the process of insulin resistance and stress adaptation in pregnant women with gestational diabetes.Medical staff screen for early gestational diabetes and take appropriate treatment.