妊娠期糖尿病孕产妇所生新生儿血糖与糖化血清白蛋白、胰岛素及C肽的关系  

Relationship between neonatal blood glucose and glycated albumin, insulin and C-peptide in neonates born by gestational diabetes women

作　　者：王琨 王蓬春[1] 杨梅[1] WANG Kun;WANG Pengchun;YANG Mei(Department of Pediatrics,Baoding First Central Hospital,Hebei Province,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院儿科

出　　处：《中国医药导报》2019年第14期132-135,共4页China Medical Herald

基　　金：吴阶平医学基金会临床科研专项资助项目(320.6750.14153)

摘　　要：目的探讨妊娠期糖尿病(GDM)孕产妇所生新生儿血糖与糖化血清白蛋白、胰岛素及C肽的关系。方法选择2017年2月~2018年4月保定市第一中心医院出生的新生儿293例,根据新生儿血糖值及新生儿母亲有无GDM分为GDM母亲新生儿低血糖组(74例)、GDM母亲新生儿正常血糖组(68例)、非GDM母亲新生儿低血糖组(16例)、非GDM母亲新生儿正常血糖组(135例)。检测并比较各组间糖化血清白蛋白、C肽、空腹胰岛素水平(FINS)、胰岛素敏感指数(ISI)及胰岛素抵抗指数(HOMA-IR),并进一步分析上述指标与新生儿血糖的相关性。结果GDM母亲所生新生儿低血糖的发生率高于非GDM母亲(P<0.05);GDM母亲新生儿低血糖组的FINS、ISI、HOMA-IR及C肽均高于GDM母亲新生儿正常血糖组,差异有统计学意义(P<0.05),非GDM母亲新生儿低血糖组与非GDM母亲的新生儿正常血糖组血清白蛋白、FINS、ISI、HOMA-IR及C肽比较,差异无统计学意义(P>0.05);进一步分析发现上述指标与GDM母亲所生新生儿血糖与FINS、ISI、HOMA-IR及C肽与血糖呈负相关(r=-0.581、-0.712、-0.642、-0.621,P<0.05),糖化血清白蛋白与血糖值变化无明显相关性(P>0.05)。结论GDM母亲所生新生儿易发生低血糖,且新生儿血糖值与胰岛素及C肽水平呈显著负相关,单独使用新生儿糖化血清白蛋白不能估测生后新生儿是否发生低血糖。Objective To investigate the relationship among blood glucose and glycated albumin,insulin and C-peptide in neonates born by gestational diabetes(GMD)women.Methods From February 2017 to April 2018,in Baoding First Central Hospital,293 neonates born were selected,according to the neonatal blood glucose and whether the neonatal mother had GDM or not,the neonates were divided into GDM mothers′neonates hypoglycemia group(74 cases),GDM mothers'normal blood glucose group(68 cases),non-GDM mothers′neonatal hypoglycemia group(16 cases),non-GDM mothers'normal blood glucose group(135 cases).Glycated albumin,C-peptide,fasting insulin level(FINS),insulin sensitivity index(ISI)and insulin resistance index(HOMA-IR)in groups were detected and compared,and the correlation between the above indicators and neonatal blood glucose was analyzed.Results The incidence of neonatal hypoglycemia in neonates born by GDM mothers was higher than that in neonates born by non-GDM mothers(P<0.05).The levels of FINS,ISI,HOMA-IR and C-peptide in GDM mothers′neonates hypoglycemia group were higher than those in GDM mothers'normal blood glucose group,the differences were statistically significant(P<0.05).There was no significant difference in glycated albumin,FINS,ISI,HOMA-IR and C-peptide in non-GDM mothers′neonatal hypoglycemia group and non-GDM mothers′normal blood glucose group(P>0.05).Further analysis showed that the above indicator were negatively correlated with FINS,ISI,HOMA-IR and C-peptide in neonates born by GDM mothers(r=-0.581,-0.712,-0.642,-0.621,P<0.05).There was no significant correlation between glycosylated serum albumin and blood glucose(P>0.05).Conclusion Neonates born by GDM mothers are prone to hypoglycemia,and the correlation between neonatal blood glucose and insulin and C-peptide level is significantly negative,with neonatal glycated albumin alone can not estimate whether hypoglycemia occurs in neonates after birth.

关 键 词：妊娠期糖尿病 新生儿 低血糖 糖化血清白蛋白 胰岛素敏感性 

分 类 号：R174.256[医药卫生—妇幼卫生保健]