妊娠期糖尿病患者氨基酸和酰基肉碱水平变化及胰岛素抵抗的关系  

Changes of amino acid and acylcarnitine levels and insulin resistance in gestational diabetes mellitus.

作　　者：叶柳静 江欣 魏小清[1] YE Liu-jing;JIANG Xin;WEI Xiao-qing(Department of Obstetrical,the First Maternal and Infant Health Hospital,Shanghai 200120,China.)

机构地区：[1]上海市第一妇婴保健院妇产科,上海200120

出　　处：《临床和实验医学杂志》2021年第4期364-367,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市科学技术委员会基金项目(编号:18411963900)。

摘　　要：目的探讨妊娠期糖尿病患者氨基酸和酰基肉碱水平变化及胰岛素抵抗的关系。方法对2019年1月至2020年1月上海市第一妇婴保健院收治的孕妇进行回顾性分析,妊娠糖尿病患者48例作为研究组,健康孕妇48例作为对照组。测定并比较2组研究对象分娩前的氨基酸、酰基肉碱、糖化血红蛋白、总胆固醇、甘油三酯、空腹血糖、空腹胰岛素的情况。观察研究组患者酰基肉碱、氨基酸与胰岛素指标之间关系。结果对照组与研究组患者在孕周、年龄等一般资料之间差异无统计学意义(P>0.05),研究组患者在体重、体质量增加、体重指数等一般资料明显高于对照组(P<0.05)。研究组游离肉碱、长链酰基肉碱(C12、C14、C16、C18)、中链酰基肉碱(C6、C8、C10)之间差异无统计学意义(P>0.05),研究组患者在短链酰基肉碱(C2、C3、C4、C5)、总酰基肉碱明显高于对照组(P<0.05)。对照组与研究组患者瓜氨酸、赖氨酸水平差异无统计学意义(P>0.05),研究组患者丙氨酸、精氨酸、甘氨酸、蛋氨酸明显高于对照组(P<0.05)。乙酰肉碱、精氨酸、蛋氨酸、丙氨酸水平与2 h血糖、空腹胰岛素、胰岛素抵抗指数呈正相关(P<0.05),甘氨酸、己酰肉碱与2 h血糖水平呈正相关(P<0.05)。结论异常的酰基肉碱、氨基酸代谢水平导致胰岛素抵抗加重,孕妇产前检测酰基肉碱、氨基酸的水平,以预测妊娠糖尿病的发病,同时也为探究糖尿病的发病机制提供了思路。Objective To investigate the relationship between amino acid and acylcarnitine levels and insulin resistance in gestational diabetes mellitus.Methods Pregnant woman in the First Maternal and Infant Health Hospital from January 2019 to January 2020 were analyzed retrospectively,48 cases of gestational diabetes patients were selected as the research group,and 48 healthy pregnant women were selected as the control group.The two groups before delivery of amino acids,acyl carnitine,glycosylated hemoglobin,total cholesterol,triglycerides,fasting glucose,fasting insulin were determined and compared.The relationship between acylcarnitine,amino acids and insulin indicators in the study group was observed.Results Comparing the general clinical data of patients in the two groups,there was no significant difference between the control group and the study group in terms of gestational age,age and other general data(P>0.05).The general data of patients in the study group were significantly higher than those in the control group(P<0.05).Compared two groups of patients with acyl carnitine levels found that team free carnitine,long-chain acyl carnitine(C12,C14,C16 and C18),the chain acyl carnitine(C6 and C8,C10),no significant differences(P>0.05)between patients with team in the short chain acyl carnitine(C2,C3,C4 and C5),total acyl carnitine significantly higher than the control group(P<0.05);By comparing the amino acid levels of the two groups,there was no significant difference in the levels of citrulline and lysine between the control group and the study group(P>0.05).Alanine,arginine,glycine and methionine in the study group were significantly higher than those in the control group(P<0.05).By comparing the relationship between acyl carnitine and amino acids and insulin in the two groups,it was found that the levels of acetyl carnitine,arginine,methionine and alanine were positively correlated with 2 h glucose,fasting insulin and insulin resistance index(P<0.05),while the levels of glycine and hexyl carnitine were positively

关 键 词：妊娠期糖尿病 氨基酸 酰基肉碱 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]