妊娠糖尿病中肌肉/脂肪质量比与胰岛素抵抗的关系  

Relationship between Muscle/Fat Mass Ratio and Insulin Resistance in Gestational Diabetes

作　　者：李彦荣 刘华[2] 王伟卓[3] 魏建勋[1] 惠旭东 LI Yan-rong;LIU Hua;WANG Wei-zhuo;WEI Jian-xun;HUI Xu-dong(Department of First Obstetrics Ward,Yan'an University Affiliated Hospital,Yan'an,Shaanxi,716000,China;Department of Second Obstetrics Ward,Yan'an University Affiliated Hospital,Yan'an,Shaanxi,716000,China;Department of Orthopedics,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710000,China)

机构地区：[1]延安大学附属医院产科一病区,陕西延安716000 [2]延安大学附属医院产科二病区,陕西延安716000 [3]西安交通大学第二附属医院骨科,陕西西安710000

出　　处：《现代生物医学进展》2020年第24期4718-4721,4700,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81001225)。

摘　　要：目的:探究妊娠糖尿病中肌肉/脂肪质量比与胰岛素抵抗的相关性。方法:选择2015年1月至2020年1月于我院接受治疗的300例产妇为研究对象,按照美国糖尿病学会(American Diabetes Association,ADA)标准将产妇区分为妊娠期糖尿病组(GDM=90例)、妊娠期糖耐量受损组(GIGT=110例)和糖耐量正常组(NGT=100例),分别检测三组产妇的总胆固醇(total cholesterol,TC)、三酰甘油(Triglycerides,TG)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、肌肉/脂肪质量比(muscle/fat mass ratio,M/F)以及空腹血清胰岛素(fasting insulin,FINS)水平。结果:(1)GDM组患者HbAlc、TC以及TG水平均明显高于GIGT组以及NGT组(P<0.05),GIGT组患者HbAlc、TC以及TG水平均明显高于NGT组(P<0.05);(2)GMD组产妇的M/F明显低于GIGT组产妇,GIGT组产妇明显低于NGT组产妇(P<0.05),而GMD组产妇FINS以及胰岛素抵抗(insulin resistance,IR)明显高于GIGT组,GIGT组明显高于NGT组(P<0.05);(3)胰岛素抵抗(IR)同M/F呈现负相关联系(r=-0.218,P<0.05),同时与HbAlc、TC、TG(r=0.346,r=0.412,r=0.372,P<0.05)等呈现正相关。结论:妊娠女性的M/F值不足同胰岛素抵抗的出现具有一定的相关性,过分强调产妇节食可能会使产妇出现较低的肌肉质量,从而增加GDM的发生风险。Objective:To explore the relationship between muscle/fat mass ratio and insulin resistance in gestational diabetes mellitus.Methods:300 pregnant women who were treated in our hospital from January 2015 to January 2020 were divided into gestational diabetes group(GDM=90 cases),gestational impaired glucose tolerance group(GIGT=110 cases)and normal glucose tolerance group(NGT=100 cases)according to the standards of American Diabetes Association(ADA).The total cholesterol(TC),triglyceride(TG),glycosylated blood red of the three groups were detected respectively Protein(HbAlc),muscle/fat mass ratio(M/F)and fasting serum insulin(fins)levels.Results:(1)The levels of HbAlc,TC and TG in GDM group were significantly higher than those in GIGT group and NGT group(P<0.05).The levels of HbAlc,TC and TG in GIGT group were significantly higher than those in NGT group(P<0.05).(2)The M/F of GMD group was significantly lower than that of GIGT group,and that of GIGT group was significantly lower than that of NGT group(P<0.05).In GMD group,fins and IR were significantly higher than those in GIGT group,GIGT group was significantly higher than NGT group(P<0.05).(3)IR was negatively correlated with M/F(r=-0.218,P<0.05),at the same time,it was positively correlated with HbAlc,TC,TG(r=0.346,r=0.412,r=0.372,P<0.05).Conclusion:The insufficient M/F value of pregnant women was related to the occurrence of insulin resistance.Overemphasis on maternal diet may lead to lower muscle mass and increase the risk of GDM.

关 键 词：妊娠糖尿病 肌肉/脂肪质量比 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]