【摘要】 目的探讨妊娠糖尿病患者胰岛β细胞功能和胰岛素抵抗及临床意义。方法孕25～32周经初筛和OGTT(同时做胰岛素释放试验)确诊的妊娠糖尿病患者56例,并于分娩后6～8周复查OG-TT(同时做胰岛素释放试验),其中31例为葡萄糖耐量正常(NGT),分娩前后样本分别确定为GDM1和NGT;25例葡萄糖耐量受损(IGT),分娩前后样本分别定为样本GDM2和IGT,四份样本均考查胰岛素曲线下面积(INSAUC)、β细胞功能指数(MBCI)及Homa胰岛素抵抗指数(Homa-IR)的变化。血浆葡萄糖、胰岛素分别采用葡萄糖氧化酶法和放免分析法测定。结果GDM2、GDM1、IGT、NGT的血糖值依次降低,四份两两比较,除GDM2和GDM1外差异均存在统计学意义(P<0.001)。GDM2、GDM1、IGT、NGT的INSAUC值依次降低,四份两两比较,差异均存在统计学意义(P<0.01)。NGT、IGT、GDM1、GDM2的MBCI值依次降低,四份两两比较,差异有统计学意义(P<0.01)。GDM2、GDM1、IGT、NGT的Homa-IR值依次降低,四份两两比较,差异均存在统计学意义(P<0.01)。结论妊娠糖尿病患者胰岛β细胞功能越差,胰岛素抵抗越强,分娩后患IGT的可能性越大。更多还原

【Abstract】 Objective To study the pancreatic islet β-cell function and insulin resistance of gestational diabetes mellitus(GDM).Methods 31 subjects with GDM were diagnosed by 75 g orally glucose tolerance test(OGTT)and inslin release test(IRT)at 25-32 weeks gestational age,took OGTT and IRT again after delivered at 6-8 weeks,and normal glucose tolerance(NGT)resulted,the sample of fore-and-aft delivery were respectively defined GDM1 and NGT group.The 25 subjects with GDM were measured with the same way,impaired glucose tolerance(IGT)resulted,the sample of fore-and-aft delivery were respectively defined GDM2 and IGT group.the plasma glucose and insulin were respectively measured by using glucose oxidase and radioimmunoassay,investigated the changes of area under insulin cure(INSAUC),insulin resistance(HOMA-IR)index and modified β-cell function index(MBCI).Results The INSAUC of GDM2、GDM1、IGT and NGT fell in turn,there were significantly differences among the groups(P<0.01).The MBCI of NGT、IGT、GDM1 and GDM2 fell in turn,there were significantly differences among the groups(P<0.01).The Homa-IR index of GDM2、GDM1、IGT and NGT fell in turn,there were significantly differences among the groups(P<0.01).Conclusion The worse pancreatic islet β-cell function of DGM,and the stronger insulin resistance was,the more incidence of GDM changing IGT was.更多还原