妊娠糖尿病患者糖负荷前后血清氨基酸与胰岛素抵抗和胰岛β细胞功能的相关性研究  

Correlation analysis between serum amino acids and insulin resistance with islet beta cell function in patients with gestational diabetes mellitus after glucose loading

作　　者：王忠德[1] 岳欣[2] 牟凯[3] Zhong-de Wang;Xin Yue;Kai Mou(Department of Internal Medicine,Zibo Maternal and Child Health Hospital,Zibo,Shandong 255029,China;Clinical Lab,Zibo Maternal and Child Health Hospital,Zibo,Shandong 255029,China;Genetic Neonatal Screening Center,Zibo Maternal and Child Health Hospital,Zibo,Shandong 255029,China)

机构地区：[1]淄博市妇幼保健院内科,山东淄博255029 [2]淄博市妇幼保健院检验科,山东淄博255029 [3]淄博市妇幼保健院遗传实验室,山东淄博255029

出　　处：《中国现代医学杂志》2020年第17期25-29,共5页China Journal of Modern Medicine

摘　　要：目的探讨糖负荷前后妊娠糖尿病(GDM)患者血清氨基酸与胰岛素抵抗和胰岛β细胞功能的关系。方法63例GDM孕妇(GDM组)和58例年龄和孕周相匹配的正常孕妇(正常组)均来自淄博市妇幼保健院产科门诊,于孕24~28周收集行口服葡萄糖耐量试验(OGTT)过程中0、1及2 h血样本。采用电化学发光法测定空腹胰岛素水平,高效液相色谱-串联质谱法(HPLC-MS/MS)检测血清氨基酸水平。结果GDM组糖负荷前后血清丙氨酸(ALA)、精氨酸(ARG)、甘氨酸(GLY)、蛋氨酸(MET)水平高于正常组(P<0.05),而亮氨酸(LEU)、苯丙氨酸(PHE)、脯氨酸(PRO)、酪氨酸(TYR)和缬氨酸(VAL)水平仅在糖负荷后高于正常组(P<0.05)。Spearman相关分析显示,糖负荷前后血清ALA(rs=0.657和0.534,P<0.05)、ARG(rs=0.382和0.278,P<0.05)、LEU(rs=0.467和0.389,P<0.05)、PHE(rs=0.506和0.398,P<0.05)、PRO(rs=0.454和0.448,P<0.05)、TYR(rs=0.474和0.438,P<0.05)、VAL(rs=0.464和0.399,P<0.05)水平均与胰岛素抵抗指数(HOMA-IR)呈正相关,而与胰岛β细胞功能(HOMA-β)无相关性(P>0.05);糖负荷前血清ALA(rs=0.343,P<0.05)、LEU(rs=0.275,P<0.05)、PHE(rs=0.293,P<0.05)、PRO(rs=0.387,P<0.05)水平与胰岛素浓度时间图像的曲线下面积呈正相关。结论糖负荷前后GDM患者存在某些氨基酸水平的改变,且与胰岛素抵抗密切相关。Objective To investigate the relationship between serum amino acid levels and insulin resistance and pancreatic beta cell function in patients with gestational diabetes mellitus(GDM)before and after glucose loading.Methods A total of 63 GDM patients and 58 normal pregnant women matched in age and gestational weeks were all from the obstetric clinic of our hospital.Serum samples were collected at 0 h,1 h and 2 h during 75 g oral glucose tolerance test(OGTT)from 24 to 28 weeks of gestation.Serum insulin levels were determined by chemiluminescence method,and serum amino acid levels were determined by high performance liquid chromatography tandem mass spectrometry.Results Compared with normal pregnant women,GDM patients showed higher plasma concentrations of alanine(ALA),arginine(ARG),glycine(GLY),methionine(MET)before and after glucose loading(P<0.05),while higher plasma concentrations of leucine(LEU),phenylalanine(PHE),proline,tyrosine(TYR)and valine(VAL)only after glucose loading(P<0.05).Spearman correlation analysis showed that serum levels of alanine(rs=0.657 and 0.534),arginine(rs=0.382 and 0.278),leucine(rs=0.467 and 0.389),phenylalanine(rs=0.506 and 0.398),proline(rs=0.454 and 0.448),tyrosine(rs=0.474 and 0.438)and valine(rs=0.464 and 0.399)were positively correlated with HOMA insulin resistance index(HOMA-IR)(P<0.05),but not with HOMA-β(P>0.05);serum levels of ALA(rs=0.343),LEU(rs=0.275),PHE(rs=0.293)and PRO(rs=0.387)were positively correlated with area under the curve of blood insulin(AUCI)before glucose loading(P<0.05).Conclusions There are some changes of amino acid levels in GDM patients before and after glucose loading,which are closely related to insulin resistance.

关 键 词：糖尿病 妊娠 氨基酸 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]