妊娠期糖尿病患者铁代谢与部分应激激素及胰岛素抵抗的关系  

Correlation of iron metabolism with some stress hormones and insulin resistance in patients with gestational diabetes mellitus

作　　者：冯艳[1] 宋新娜[1] 徐晓萌 张立[1] 李学龙[1] 李海娟[1] 赵善鹏 Feng Yan;Song Xinna;Xu Xiaomeng;Zhang Li;Li Xuelong;Li Haijuan;Zhao Shanpeng(Department of Clinical Nutrition,Yantai Yuhuangding Hospital,Yantai 264000,Chin)

机构地区：[1]烟台毓璜顶医院临床营养科,264000 [2]济宁市人民医院体检中心

出　　处：《中华内分泌代谢杂志》2018年第7期563-566,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的分析妊娠期糖尿病（GDM）患者铁代谢指标与应激激素及胰岛素抵抗的关系。方法选择2015年1月至11月孕24～28周在烟台毓璜顶医院常规产检，确诊为GDM的75例患者，按年龄段1∶1配对，75名正常孕妇作为对照组。检测2组患者血糖、胰岛素、应激激素、铁代谢指标水平，并利用稳态模型评估的胰岛素抵抗指数（HOMA-IR）评价2组患者胰岛素抵抗程度，采用多元线性回归法分析铁代谢指标与应激激素水平及胰岛素抵抗的相关性。结果GDM组去甲肾上腺素、肾上腺素水平均高于对照组（均P〈0.05），2组间皮质醇水平差异无统计学意义（P〉0.05）。GDM组铁蛋白、血清铁、转铁蛋白饱和度均高于对照组（均P〈0.01）。多元线性回归结果显示，GDM组患者应激激素肾上腺素、去甲肾上腺素、皮质醇与铁蛋白水平均呈正相关（均P〈0.05）；肾上腺素、皮质醇水平与转铁蛋白饱和度均呈正相关（均P〈0.05）。2组患者HOMA-IR与铁蛋白、转铁蛋白饱和度均呈正相关（P〈0.05或P〈0.01）。结论铁负荷过度可能参与了妊娠期糖尿病患者应激适应障碍和胰岛素抵抗的发生。ObjectiveTo investigate the association of iron with stress hormones and insulin resistance in patients with gestational diabetes mellitus （GDM）.MethodsSeventy-five pregnant women diagnosed as GDM during 24-28 weeks were collected from January to November 2015 in Yantai Yuhuangding Hospital, and 75 normal pregnant women were used as control group. Blood glucose, insulin, stress hormones and iron metabolism related indexes were detected. Homeostasis model assessment for insulin resistance （HOMA-IR） was used to evaluate insulin resistance, and the correlation of iron metabolism with stress hormones and insulin resistance was analyzed.ResultsCompared with control group, norepinephrine （NE） and epinephrine （E） levels were higher in GDM group （both P〈0.05）, but there was no significant difference in cortisol level between two groups （P〉0.05）. Serum ferritin （SF）, serum iron, and transferrin saturation levels were higher in GDM group than those in control group（all P〈0.01）. Multivariate logistic analysis showed that cortisol, E, and NE levels were positively correlated with SF level in GDM group （all P〈0.05）. Cortisol and E levels were positively correlated with transferrin saturation （both P〈0.05）. SF and transferrin saturation were positively correlated with HOMA-IR in two groups （P〈0.05 or P〈0.01）.ConclusionIron overload may involve in dysfunction of stress adaptation and insulin resistance in patients with GDM.

关 键 词：妊娠期糖尿病 应激激素 铁代谢指标 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]