妊娠期糖尿病患者血清性激素、25(OH)D3水平、胰岛功能改变及其内在关系分析  

Changes of serum sex hormones,25(OH)D3 levels,islet function and their internal relationship in patients with gestational diabetes

作　　者：李耕[1] 李源源[1] 倪维[2] Li Geng;Li Yuanyuan;Ni Wei(Wuhan Hospital of Traditional Chinese Medicine,Wuhan,430014,China;Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China)

机构地区：[1]武汉市中医医院检验科,430014 [2]湖北省中医院检验科,武汉430061

出　　处：《中华内分泌外科杂志》2021年第2期178-181,共4页Chinese Journal of Endocrine Surgery

基　　金：湖北省卫生健康委员会科研项目(WJ2019F164);生物医学分析化学教育部重点实验室(武汉大学)2018年开放课题基金项目(ACBM2018010);湖北省中医院昙华林学子培养项目(P-20190319-0535)。

摘　　要：目的探讨妊娠期糖尿病(gestafional diabetes mdlitus,GDM)患者血清性激素、25-羟维生素D(25 hydroxyvitamin D3,25(OH)D3)水平、胰岛功能改变,并分析其内在关系。方法选取2018年3月至2019年9月武汉市中医医院检验科收治的50例GDM患者为GDM组,另选取同期健康孕妇50例为对照组,比较两组患者的血清性激素(雌激素、孕激素)水平、25(OH)D3水平、胰岛功能[空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)]、胰岛β细胞功能指数(isletβcell function index,HOMA-β),采用Person分析血清性激素、25(OH)D3水平、胰岛功能改变间的相关性,采用二元Logistic分析GDM的影响因素。结果GDM组的雌激素水平、孕激素水平、FINS水平、HOMA-IR明显高于对照组[(6525.28±2095.51)vs(2259.02±717.75)pg/ml,(554.34±32.85)vs(385.34±24.59)ng/ml,(12.69±3.93)vs(9.68±3.19)mU/L,(3.06±1.06)vs(2.01±0.63)],GDM组的25(OH)D3、HOMA-β明显低于对照组[(17.46±5.59)vs(21.51±7.14)ng/ml,(137.31±32.11)vs(281.76±54.02)],差异均有统计学意义(P<0.05)。经Pearson分析,性激素与FINS、HOMA-IR呈正相关(P<0.05),与HOMA-β呈负相关(P<0.05);25(OH)D3与HOMA-β呈正相关(P<0.05),与孕激素呈负相关(P<0.05);FINS与HOMA-IR呈正相关(P<0.05),HOMA-IR与HOMA-β呈负相关(P<0.05)。25(OH)D3、HOMA-β是GDM的危险因素(P<0.05),FINS、HOMA-IR是GDM的保护因素(P<0.05)。结论GDM患者性激素水平较高,25(OH)D3、HOMA-β水平较低,存在维生素D缺乏或不足和胰岛素分泌下降,25(OH)D3与HOMA-β存在相关性。Objective To investigate the changes of serum sex hormones,25-hydroxyvitamin D3,25(OH)D3]levels and islet function in patients with gestational diabetes mdlitus(GDM),and to analyze their intrinsic relationships.Methods 50 GDM patients admitted to the Department of Clinical Medicine of Wuhan Traditional Chinese Medicine Hospital from Mar.2018 to Sep.2019 were selected as the study group,and 50 healthy pregnant women were selected as the control group.Serum level of sex hormones,25(OH)D3 level,islet function[Fasting insulin(FINS),Insulin resistance index(HOMA-IR),Islet β cell function index(HOMA-β)],the correlations between serum sex hormones,25(OH)D3 levels,and islet function changes were analyzed using Person,and the influencing factors of GDM were analyzed using binary logistic.Results The estrogen level,progesterone level,FINS level and HOMA-IR of the observation group were significantly higher than those of the control group[(6525.28±2095.51)vs(2259.02±717.75)pg/ml,(554.34±32.85)vs(385.34±24.59)ng/ml,(12.69±3.93)vs(9.68±3.19)mU/L,(3.06±1.06)vs(2.01±0.63)].25(OH)D3 and HOMA-βin the observation group were significantly lower than those in the control group[(17.46±5.59)vs(21.51±7.14)ng/ml,(137.31±32.11)vs(281.76±54.02)],the differences were statistically significant(P<0.05).According to Pearson analysis,sex hormones were positively correlated with FINS and HOMA-IR(P<0.05)and negatively correlated with HOMA-β(P<0.05);25(OH)D3 was positively correlated with HOMA-β(P<0.05)and progestin was negatively correlated(P<0.05);FINS was positively correlated with HOMA-IR(P<0.05),and HOMA-IR was negatively correlated with HOMA-β(P<0.05).25(OH)D3 and HOMA-βwere risk factors for GDM(P<0.05),and FINS and HOMA-IR were protective factors for GDM(P<0.05).Conclusions GDM patients have higher levels of sex hormones,lower levels of25(OH)D3,HOMA-β,vitamin D deficiency or deficiency,and decreased insulin secretion.There is a correlation between 25(OH)D3 and HOMA-β.

关 键 词：妊娠期糖尿病 性激素 25-羟维生素D 胰岛功能改变 

分 类 号：R587.1[医药卫生—内分泌]