妊娠糖尿病患者分娩后胰岛素抵抗和胰岛B细胞功能研究  

Insulin resistance and B cell function after delivery in gestational diabetes mellitus.

作　　者：陈宇[1] 王立伟[2] 李玲[1] 厉平[1] 石英[3] 刘玉辉[4] 刘聪[1] 

机构地区：[1]中国医科大学附属盛京医院内分泌科,沈阳110004 [2]北京市丰台区南苑医院内科,北京100016 [3]沈阳维康医院内分泌科,沈阳110021 [4]沈阳军区总医院,沈阳110016

出　　处：《中国实用内科杂志》2011年第1期42-44,共3页Chinese Journal of Practical Internal Medicine

基　　金：辽宁省科学技术计划(2008225009-21);辽宁省教育厅资助课题(05L482)

摘　　要：目的研究妊娠糖尿病患者分娩后胰岛素抵抗、胰岛B细胞功能状态,探讨其在分娩后糖耐量异常发生发展中的作用。方法对2008-09-01—2009-07-10中国医科大学附属盛京医院内分泌科根据口服糖耐量试验筛选出8例有妊娠糖尿病史的妇女妊娠后糖耐量正常(NGT)者,另选取8例有妊娠糖尿病病史的妇女妊娠后糖耐量异常(IGT)者与之匹配。应用高胰岛素-正葡萄糖钳夹技术和静脉葡萄糖耐量试验评估胰岛素抵抗和胰岛B细胞功能。结果 NGT组和IGT组体重指数(BMI)及三酰甘油比较差异无统计学意义(P<0.05);IGT组葡萄糖输注速率(GIR)明显低于NGT组(5.70±1.14对7.79±1.75,P<0.05);NGT组胰岛素一时相分泌量高于IGT组(5.32±0.37对4.35±0.46,P<0.05);两组间胰岛素第二时相分泌量(4.35±0.31对4.38±0.56,P>0.05)比较差异无统计学意义。结论妊娠糖尿病患者分娩后糖耐量异常者较糖耐量正常者存在更为明显的胰岛素抵抗及胰岛B细胞功能缺陷。Objective To investigate insulin resistance and B cell function after delivery in the gestational diabetes mellitus （GDM）. Methods According to oral glucose tolerance test （OGTT） ,8 women with a history of GDM and normal glueose tolerance were take as NGT group. Another 8 women with a history of GDM and impaired glucose tolerance were take as IGT group. Insulin resistance was measured using hyperinsulin-euglycemic clamp, and B-cell function was assessed by intravenous glucose tolerance test （IVGTT）. Results BMI and triglyceride in NGT group and IGT group were similar. The glucose injection rate of IGT group was lower than that in NGT group（5.70 ± 1.14 vs 7.79 ± 1.75 ,P 〈0. 05）. The first phase insulin secretion of NGT group was higher than that of IGT group（5.32 ±0. 37 vs 4. 35 ±0. 46,P 〈0. 05） ;there was no difference between the IGT group and the NGT group at the second phase （4.35 ± 0. 31 vs 4. 38 ±0. 56,P 〉 0.05 ）. Conclusion There is more severe insulin resistance and more severe B cell function impairment in women with a history of GDM and impaired glucose tolerance than in those with normal glucose tolerance.

关 键 词：妊娠糖尿病 胰岛素抵抗 B细胞功能 正葡萄糖高胰岛素钳夹技术 静脉葡萄糖耐量试验 

分 类 号：R5[医药卫生—内科学]