妊娠糖耐量低减患者胰岛素抵抗和胰岛β细胞分泌功能  

Changes of insulin resistance and function of islet β cell in subjects with gestational impaired glucose tolerance

作　　者：赖丽萍[1] 邵豪[1] 陆泽元[1] 李翠吟 邹钢[1] 尤晓玲 庄荀芳 陈春莹[2] 

机构地区：[1]广东省深圳市第四人民医院内分泌科,518033 [2]深圳市第四人民医院妇产科

出　　处：《中国妇幼保健》2008年第14期1913-1915,共3页Maternal and Child Health Care of China

基　　金：深圳市科技和信息局资助项目(200602037)

摘　　要：目的:探讨妊娠糖耐量低减(GIGT)患者胰岛素抵抗和胰岛β细胞分泌功能的变化。方法:分析125例糖耐量正常(NGT)孕妇、61例GIGT孕妇和59例妊娠糖尿病(GDM)孕妇的胰岛素抵抗(IR)和胰岛β细胞分泌功能,采用稳态模式胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗,稳态模式胰岛β细胞功能指数(HBCI)、30min净增胰岛素/30min净增血糖(ΔⅠ30/ΔG30)和ΔⅠ30评价胰岛β细胞分泌功能。结果:GIGT组和GDM组HOMA-IR高于NGT组,GDM组的HOMA-IR高于GIGT组,差异均有统计学意义(P<0.05);GIGT组和GDM组ΔⅠ30/ΔG30和HBCI低于NGT组,差异有统计学意义(P<0.05～0.01),GDM组的HBCI低于GIGT组,差异有统计学意义(P<0.05),GIGT组与GDM组的ΔⅠ30/ΔG30和ΔⅠ30比较无统计学差异。结论:GIGT的发病机制为胰岛素抵抗增强和胰岛β细胞分泌功能缺陷,且胰岛素早期分泌功能受损;GIGT应被视作病理状态,应该与GDM患者采取类似的防治方法。Objective： To investigate the changes of insulin resistance （IR） and function of islet β cell in subjects with gestational impaired glucose tolerance （GIGT） . Methods： 125 subjects with normal glucose tolerance （NGT）, 61 GIGT and 59 gestatiunal diabetes mellitus （GDM） were observed. Homeostasis model insulin resistance index （HOMA- IR） was applied to assess the status of insulin resistance, Homeostasis β -cell function index （HBCI）, 30min net increment of insulin/30min net increment of glucose （△I30/△G30 ） and △I30 were used to evaluate the basic function of islet β cells. Results： HOMA -IR in GIGT and GDM were higher than in NGT, HOMA -IR in GDM was higher than in GIGT, there were significant difference （ all P 〈0. 05） ; Compared with NGT, HBCI and △I30/AG30 were significandy decreased （ P 〈 0. 05 ～ 0. 01 ）, HBCI in GDM was lower than in GIGT （P 〈 0. 05）. There were no significant difference in △I30/△G30 and △I30 in GDM and GIGT. Conclusion： The increase of insulin resistance and decrease of islet β cell function may result in subjects with GIGT, and show a defect of the early phase of insulin secretion. GIGT should be regarded as a pathologic states and be treaded similarly to the patient with GDM.

关 键 词：胰岛素抵抗 胰岛Β细胞功能 糖耐量低减 妊娠 

分 类 号：R714.147[医药卫生—妇产科学]