不同程度妊娠期糖尿病患者糖代谢异常与脂代谢紊乱关系的研究  

Study of lipid and glucose metabolism and their relationship in patients with different extent gestational diabetes mellitus

作　　者：朱海燕[1] 姜桂英[1] 吴庆庆[1] 胡江[1] 

机构地区：[1]北京首都医科大学附属复兴医院产科,100038

出　　处：《中国妇产科临床杂志》2013年第5期413-416,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨新诊断标准下不同程度妊娠期糖尿病（GDM）患者糖脂代谢变化及两者的关系。方法选取于2010年至2011年首都医科大学附属复兴医院产检的孕妇,孕24-28周、行75g葡萄糖耐量试验（OGTT）及血脂六项。根据OGTT结果,分为GDM组共266例,其中任意一项异常GDM1组148例,两项异常GDM2组86例,三项异常GDM3组32例。正常组NGT 100例。结果①与NGT组比较,GDM组胰岛素抵抗指数HOAM-IR增高（4.18±1.67、3.13±1.22）、胰岛细胞分泌功能指数HBCI降低[（5.41±0.44）、（5.93±0.48）],甘油三酯TG增高（3.18±0.85、2.77±0.67）mmol/L、载脂蛋白ApoB/ApoA1（0.47±0.14、0.42±0.14）差异有统计学意义（P〈0.05）;②组内GDM3组HOAM-IR（5.06±1.79）,LnHBCI（5.09±0.48）、TG（3.78±1.12）mmol/L、Ln（TG/HDL-C）（0.25±0.14）、ApoB/ApoA1（0.56±0.17）ApoB（1.13±0.26）g/L较GDM1、GDM2变化显著,差异有统计学意义（P〈0.05）;③TG与空腹血糖FPG、胰岛素FIN、糖化血红蛋白HbA1c水平及HOMA-IR呈正相关;高密度脂蛋白HDL-C与FPG、FNS及HOMA-IR水平呈负相关;ApoA1与HBCI呈正相关。结论不同程度妊娠期糖尿病患者存在糖脂代谢紊乱,血脂异常与胰岛功能和胰岛素抵抗存在着密切关系。Objective To investigate the glucose metabolism and lipid metabolism and their relationship in patients with different extent Gestational diabetes mellitus.Methods There were totally 384pregnant women at 24-28gestational week received antenatal care in the clinic of our hospital from 2010to 2011.Each woman underwent 75g OGTT and lipid testing.Patients were divided into normal group（NGT,n=100）,and GDM group（n= 266）which including mild GDM1（n=148）,moderate GDM2（n=86）and severe GDM3（n=32）with respect to the results of OGTT.Results The levels of HOMA-IR[（4.18±1.67）and（3.13±1.22）],HBCI[（5.41 ±0.44）,（5.93±0.48）],TG[（3.18±0.85）and（2.77±0.67）mmol/l and ApoB/ApoA1（0.47±0.14）and（0.42±0.14）]were significantly different between GDM and NGT（P0.05）.2.The levels of HOAM-IR（5.06±1.79）,LnHBCI（5.09±0.48）,TG（3.78±1.12）mmol/L,Ln（TG/HDL-C）（0.25±0.14）,ApoB/ ApoA1（0.56±0.17）and ApoB（1.13±0.26）g/Lin GDM3were significantly different from GDM1or GDM2（P0.05）.3.The TG level was positively correlated with the levels of FPG,FIN,HbA1cand HOMA-IR;the level of HDL-C was negatively correlated with the levels of FPG,HbA1cand HOMA-IR,but positively with the levels of HBCI and ApoA1.Conclusion The patients with different extent gestational diabetes mellitus have abnormal glucosemetabolism and lipidmetabolism.The serum lipid disorder is closely associated with pancreatic islets secretion function and insulin resistance.

关 键 词：新诊断标准 妊娠期糖尿病 糖代谢 脂代谢 

分 类 号：R714.2[医药卫生—妇产科学]