妊娠糖尿病患者血清Nesfatin-1与胰岛素抵抗及胰岛细胞功能的相关性研究  

Serum nesfatin-1 levels in gestational diabetes mellitus in relation to insulin resistance and pancreatic β-cell function

作　　者：丁璐[1] 胡红琳[1] 代芳[1] 宣蓉[1] 王长江[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230022

出　　处：《中华内分泌代谢杂志》2014年第3期210-213,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：安徽中医学院中医药管理局重点学科一中医内分泌学科开放基金（2011nfmxk004）

摘　　要：探讨妊娠糖尿病患者胰岛素抵抗、胰岛细胞功能与空腹血清Nesfatin-1之间的关系。选取妊娠24～28周孕妇90例，根据口服葡萄糖耐量试验（OGTr）结果分为妊娠糖尿病组（GDM）45例，糖耐量正常组45例，并以空腹血糖（FPG）7．0mmol／L为切割点，将GDM组分为GDMl组和GDM2组。检测各组空腹血清Nesfatin-1水平，同时测定OGTY各点血糖、胰岛素和C肽等，并计算稳态模型评估的胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）、胰岛素曲线下面积（INSAUC）／血糖曲线下面积（PGAUC）和早期胰岛素分泌功能指数，分析Nesfatin-1与这些指标之间的关系。GDMl组和GDM2组的Nesfatin-1水平均显著高于对照组（P〈0．01）；GDM2组的Nesfatin-1水平高于GDMl组（P〈0．05）。Pearson相关分析显示，Nesfatin-1与FPG、30min血糖、1h血糖、2h血糖、HOMA-IR、PGAUC正相关，与HOMA-β负相关。多元逐步回归分析显示，FPG是影响Nesfatin-1水平的独立相关因素。Nesfatin-1与胰岛素抵抗正相关。与胰岛细胞功能负相关，其可能在妊娠糖尿病的发病机制中发挥一定的作用。The association of serum nesfatin-1 levels with insulin resistance and pancreatic β-cell function in gestational diabetes mellitus was investigated. Oral glucose tolerance test （OGTT） was performed in ninety pregnant women from 24 to 28 gestational weeks. They were divided into three groups according to OGTT ： 45 nomal controls, 27 gestational diabetes mellitus with fasting plasma glucose （FPG） of 5. 1 mmoL/L to 7. 0 mmol/L （ GDM1 ）, 18 gestational diabetes mellitus with FPG more than 7.0 mmol/L （ GDM2 ）. Serum nesfatin-1 levels were significantly higher in patients with GDM1 and GDM2 than in controls （P〈0.01）, and in GDM2 group it was also higher than GDM1 group（P〈0.05 ）. Fasting serum nesfatin-1 was positively correlated with FPG, 30 min plasma glucose, 1 h plasma glucose, 2 h plasma glucose, homeostasis model assessment for insulin resistance, and PGAuc, but negatively correlated with homeostasis model assessment for β-cell function. Furthermore, multiple stepwise regression analysis showed that FPG was the independent influencing factor of serum nesfatin-1 level. Nesfatin-1 was positively correlated with insulin resistance, while negatively correlated with pancreatic β-cell function. Nesfatin-1 may play a role in the pathogenesis of gestational diabetes mellitus.

关 键 词：NESFATIN-1 妊娠糖尿病 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R714.256[医药卫生—妇产科学]