妊娠糖尿病患者胰岛素抵抗与血清C反应蛋白水平的相关性研究  

Research on the correlation between insulin resistance and C-reactive protein level of gestational diabetes mellitus

作　　者：沈春芳[1] 洪洁[1] 张翼飞[1] 顾卫琼[1] 王卫庆[1] 李小英[1] 王敏敏[2] 喇端端[2] 侍庆[2] 宁光[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌科上海市内分泌代谢病临床医学中心 [2]上海交通大学医学院附属瑞金医院妇产科,上海200025

出　　处：《内科理论与实践》2008年第1期37-40,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:研究妊娠糖尿病(GDM)患者与正常妊娠妇女胎盘激素、超敏C反应蛋白(hs-CRP)与妊娠胰岛素抵抗和胰岛β细胞分泌功能的关系,分析发生GDM的危险因素,探讨GDM的发病机制。方法:GDM孕妇和正常孕妇各50例,均测胎盘激素、hs-CRP、血糖及胰岛素水平。结果:GDM组的hs-CRP水平明显高于正常对照组(P<0.05)。2组的胎盘激素水平(雌激素、孕激素、泌乳素)无统计学意义。GDM组的早期相胰岛β细胞分泌功能(△I30/△G30)明显低于对照组,P<0.001。hs-CRP与孕前体重、孕前体重指数(BMI)、空腹胰岛素、稳态模式评估法胰岛素抵抗指数(HOMA-IR)呈正相关(r=0.287、0.289、0.248、0.299,P<0.01),与△I30/△G30呈负相关(r=-0.509,P<0.001)。在纠正了孕前体重、孕前BMI、糖筛查时的体重和BMI后,hs-CRP与空腹胰岛素、HOMA-IR不再相关(P>0.05)。结论:炎症反应参与并加重妊娠胰岛素抵抗;GDM孕妇存在早期相胰岛β细胞分泌缺陷。Objective To investigate the risk factors and pathogenesis of gestational diabetes mellitus （GDM）, via comparing the differences of placental hormones, high sensitivity C-reactive protein （hs-CRP）, insulin resistant, as well as β-cell function in GDM and nondiabetic pregnant women. Methods Fifty patients with GDM and 50 nondiabetic pregnant women as controls group were enrolled into this study. Serum placental hormones, hs-CRP, glucose and insulin were detected. Results Serum hs-CRP level in GDM was significantly higher than that in the control group. No significant difference was found in serum placental hormone. Insulinogenic index of β-cell （△I30/△G30） in GDM patients was significantly lower than that of the controls, hs-CRP was positively related with pre-pregnant weight, pre-pregnant body-mass-index （BMI）, fasting insulin, and homeostasis model assessment of insulin resistance （HOMA-IR） （r=0.287,0.289,0.248,0.299, P〈0.01）, but was inversely related with △I30/△G30（r=-0.509 ,P〈0.001）. After weight and BMI controled, no relationship was found between hs-CRP either with fasting insulin or HOMA-IR （P〉0.05）. Conclusions Inflammation is associated with insulin resistance during pregnancy. β-cell defect in secretion is found in women with GDM.

关 键 词：妊娠糖尿病 胰岛素抵抗 超敏C反应蛋白 

分 类 号：R714.2[医药卫生—妇产科学]