血清鸢尾素水平与妊娠糖尿病患者胰岛素抵抗和胰岛细胞功能的关系

Association of serum Irisin level with insulin resistance and islet cell function in patients with gestational diabetes mellitus

目的 在妊娠糖尿病(GDM)患者中探讨血清鸢尾素水平与胰岛素抵抗和胰岛β细胞功能的关系。方法 选取妊娠24周~28周的孕妇300例,根据OGTT结果分为GDM组(n=132)和正常对照组(NGT,n=168),测定所有孕妇的血糖、血脂、胰岛素水平,计算胰岛素抵抗指数HOMA-IR和胰岛β细胞功能的参数(HOMA-β),分析血清鸢尾素水平与HOMA-IR和HOMA-β的关系。结果 GDM患者血清鸢尾素水平显著低于NGT组(P<0.01);血清鸢尾素水平与HOMA-IR呈负相关(r=-0.228,P<0.001),与HOMA-β呈正相关(r=0.220,P<0.001);进行多元逐步回归分析提示,血清鸢尾素水平是HOMA-IR(β=-0.205,P<0.01)和HOMA-β(β=0.198,P<0.01)的独立影响因素;在GDM患者中,随着血清鸢尾素水平的升高,HOMA-IR逐渐降低,HOMA-β逐渐升高。结论 血清鸢尾素水平与GDM患者胰岛素抵抗和胰岛β细胞功能密切相关。

Objective To investigate the relationship between serum Irisin level and insulin resistance and pancreatic β-cell function in patients with gestational diabetes mellitus(GDM).Methods A total of 300 pregnant women from 24 to 28 weeks of gestation were enrolled and divided into the GDM group(n= 132) and the control group(NGT,n= 168) according to the results of OGTT. Blood glucose, blood lipid and insulin level were measured. Insulin resistance index such as HOMA-IR and islet β-cell function parameters(HOMA-β) were calculated based on fasting blood and insulin. The relationship between serum Irisin level and HOMA-IR and HOMA-β was analyzed.Results The serum Irisin level in GDM group was significantly lower than that in NGT group(P< 0. 01). Serum Irisin level was negatively correlated with HOMA-IR(r=-0. 228,P< 0. 001) and positively correlated with HOMA-β(r= 0. 220,P< 0. 001). Multiple stepwise regression analysis indicated that serum Irisin level was an independent influencing factor of HOMA-IR(β=-0. 205,P< 0. 01) and HOMA-β(β=0. 198,P< 0. 01). In patients with GDM, with the increase of serum Irisin level, HOMA-IR gradually decreased and HOMA-β gradually increased.Conclusion Serum Irisin level is closely related to insulin resistance and islet β-cell function in patients with GDM.