【摘要】 目的探讨妊娠期糖尿病与正常妊娠人的胰岛素抵抗及胰岛素分泌功能的差异.方法将40名GDM孕妇与40名正常孕妇按年龄、产次、民族、孕周、孕次配对后测定两组孕28～30周的BMI、WHR以及75 g口服葡萄糖耐量试验血糖值、空腹胰岛素(FINS)及餐后2 h胰岛素水平(2hINS),应用稳态模式胰岛素抵抗指数(HOMA-IR)作为胰岛素抵抗指标,稳态模式胰岛β细胞功能指数(HBCI)作为胰岛素分泌指标,并对两组孕妇的这些指标及临床特征进行对比分析.结果 (1)与对照组比较,GDM组首诊时的BMI、OGTT时的WHR、FPG、75 gOGTT2hPG、FINS、2hINS比对照组明显升高(P<0.05),表现为持续的高胰岛素状态;(2)GDM组HOMA-IR比对照组明显升高(P<0.01).结论 GDM人群BMI偏大和向心性肥胖的临床特征更为突出.主要以外周组织的胰岛素抵抗和胰岛素持续的高分泌状态为主.更多还原

【Abstract】 Objective To investigate whether insulin secretion and resistance are different in normal glucose tolerant and gestational diabetes mellitus women during late pregnancy.Methods 40 gestational diabetes mellitus(GDM)patients(GDM group)were paired with 40 normal glucose tolerant pregnant patients(control group)according to age(±1yr),race,parity,gestational weeks(±1wk)and gravidity.The body mass index(BMI),waist/hip ratio(WHR),fasting plasma glucose(FPG),75 g OGTT 2h-postprandial glucose(2hPG),fasting insulin(FINS),2h-postprandial insulin(2hINS)in patients at 28～30 weeks of gestation in the two groups were measured.Insulin resistance was measured by homeostasis insulin resistance index(HOMA-IR),insulin secretion function was evaluated by homeostasis β-cell index(HBCI).The indexes mentioned above were compared between the two groups.Results(1)Compared with the control group,BMI atbooking,WHR at OGTT,FPG,2hPG,FINS、2hINS were significantly higher than those in GDM group(P<0.05).(2)HOMA-IR transformed to logarithm in GDM group was significantly higher than that of control group(t=3.26,P=0.002).However,no significant differences in HBCI between two groups were found(P>0.01).Conclusions GDM women in the third trimester have significant trend of great BMI and central obesity.GDM are additionally characterized by peripheral insulin resistance and persisting hyperinsulinemia states independent of defective beta-cell secretion.更多还原