妊娠糖尿病妇女血清有机污染物水平与胰岛素抵抗的相关性分析  

Relationship between Serum Concentrations of Persistent Organic Pollutants and Insulin Resistance in Women with Gestational Diabetes Mellitus

作　　者：马志强 许崇艳[2] MA Zhiqiang;XU Chongyan(Department of Internal Medicine,Maternal Child Health Hospital,Rizhao 276826,China;Department of Hematology,Rizhao Hospital of Traditional Chinese Medicine,Rizhao 276826,China)

机构地区：[1]山东省日照市妇幼保健院内科,日照276826 [2]山东省日照市中医医院血液科,日照276826

出　　处：《宁夏医科大学学报》2020年第9期896-900,共5页Journal of Ningxia Medical University

摘　　要：目的研究妊娠期糖尿病(gestational diabetes mellitus,GDM)妇女血清持久性有机污染物(persistent organic pollutants,POPs)血清水平和胰岛素抵抗(insulin resistance,IR)之间的相关性。方法GDM妇女107例,气相色谱仪检测血清POPs并计算总和POPs(ΣPOPs)。多元线性回归模型评估个体POPs水平和IR参数间的关系。结果多氯联苯(PCB)同源物138、180与2 h血糖及空腹免疫反应性胰岛素(IRI)水平呈正相关。4,4′-二氯二苯二氯乙烯(p,p′-DDE)、PCB同源物、六氯苯(HCB)及ΣPOPs与2 hIRI呈正相关。PCB同源物、HCB、ΣPOPs与稳态模式评估法测定胰岛素抵抗指数(HOMA-IR)水平呈正相关。p,p′-DDE、CB同源、HCB、ΣPOPs与胰岛素敏感指数(ISI)呈负相关。糖化血红蛋白(HbA1c)与POPs水平无相关性。结论GDM女性血清中PCB同源物、p,p′-DDE等POPs可以加重IR。相关研究提示通过制定防范措施,包括改善饮食和生活方式可能有效干预POPs导致的IR。Objective To investigate the relationship between serum concentrations of persistent organic pollutants(POPs)and insulin resistance(IR)in women with gestational diabetes mellitus(GDM).Methods A total of 107 women with gestational diabetes mellitus were chosen.Serum POPs concentration was detected by gas chromatograp and ∑ POPs was computed.Multivariate linear regression model was used to analyze the relationship between individual POPs concentration(independent variable)and insulin resistance parameters(dependent variable).Results Polychlorinated biphenyl(PCB)congeners 138 and 180 were positively associated with 2 h glucose levels and fasting immunoreactive insulin(IRI).A positive association of p,p′-dichlorodiphenyl dichloroethylene(p,p′-DDE),PCBs(138,153 and 180),hexa-chlorobenzene,and ∑ POPs with 2 h IRI was found.Serum concentrations of PCBs(138,153 and 180),hexa-chlorobenzene,and ∑ POPs were also positively associated with homeostasis model assessment determined insulin resistant index(HOMA-IRI)levels.Moreover,p,p′-DDE,PCBs(138,153 and 180),hexa-chlorobenzene,and ∑ POPs were negatively associated with insulin sensitivity index(ISI)levels.No significant association was found between glycated hemoglobin(HbA1 c)and the concentrations of any POPs.Conclusion Our findings suggest that certain serum POPs is a risk factor contributing to insulin resistance for women with GDM.It is suggested that the development of preventive measures,including the improvement of diet and lifestyle,may effectively interfere with IR caused by POPs.

关 键 词：妊娠期糖尿病 持久性有机污染物 胰岛素抵抗 胰岛素抵抗指数 胰岛素敏感指数 

分 类 号：R714.256[医药卫生—妇产科学]