不同类型OGTT血糖异常的GDM孕妇胰岛功能指标特征分析  

Characteristic analysis of the islet function indexes of pregnant women with gestational diabetes mellitus and with different types of abnormal oral glucose tolerance test

作　　者：曹水芳 章先瑜 CAO Shuifang;ZHANG Xianyu(Xuancheng Central Hospital,Anhui Province,242000)

机构地区：[1]安徽省宣城市中心医院,242000

出　　处：《中国计划生育学杂志》2025年第2期429-433,共5页Chinese Journal of Family Planning

摘　　要：目的:分析75g葡萄糖耐量试验(OGTT)血糖异常不同类型的妊娠期糖尿病(GDM)孕妇胰岛功能指标特征。方法:收集2021年1月-2023年12月本院诊治的GDM孕妇210例作为GDM组,非GDM孕妇100例作为对照组。根据OGTT结果将GDM组再分为GDM-A组90例[仅空腹血糖(FPG)高于上限]、GDM-B组71例[FPG正常范围,但服糖后60min(G60)或(和)服糖后120min(G120)高于上限]、GDM-C组49例[FPG、G60或(和)G120高于上限]。比较各组临床资料、胰岛素分泌特点及胰岛素功能指标差异。结果:GDM组年龄≥35岁占比、孕前BMI均大于对照组,且GDM-C组年龄≥35岁占比、孕前BMI大于GDM-A组与GDM-B组(均P<0.05),而GDM-A组与GDM-B组无差异(P>0.05)。INS0、INS60及INS120,GDM各组均高于对照组(P<0.05),INS0在GDM各组间无差异(P>0.05);INS60,GDM-B组与GDM-C组无差异但均高于GDM-A组(P<0.05);INS120,GDM-A组、GDM-B组、GDM-C组逐渐递增(P<0.05)。GDM-C组HOMA-IR值高于GDM-B组、HOMA-β低于GDM-B组,且GDM-B组、GDM-C组HOMA-IR值均高于对照组和GDM-A组,HOMA-β均低于对照组和GDM-A组(P<0.05),对照组与GDM-A组HOMA-IR、HOMA-β无差异(P>0.05)。年龄≥35岁、BMI≥25kg/m2、G60或(和)G120高于上限、FPG、G60或(和)G120高于上限是GDM孕妇胰岛素抵抗的独立危险因素(均P<0.05)。结论:GDM孕妇中,与单纯空腹血糖升高患者比较,服糖后血糖升高的患者胰岛素抵抗发生风险更高。Objective: To analyze the islet function indexes characteristic of pregnant women with gestational diabetes mellitus(GDM) and with different types of abnormal 75g oral glucose tolerance test(OGTT). Methods: From January 2021 to December 2023, 210 pregnant women with GDM were selected in group A and 100 pregnant women without GDM were selected in group B. According to the OGTT results of the women in group A, the women were divided into group A1(90 women with fasting plasma glucose(FPG) level above the upper limit only), group A2(71 women with normal FPG level and with the levels of G60 or/and G120 above the upper limit) and group A3(49 women with the levels of FPG and G60 or/and G120 above the upper limit). The clinical data, the insulin secretion characteristics and the insulin function indexes values of the women were compared among these groups. Results: The proportion of the age ≥35 years old and the pre-pregnancy BMI value of the women in group A were significantly higher than those of the women in group B. The proportion of the age ≥35 years old and the pre-pregnancy BMI value of the women in group A3 were significantly higher than those of the women in group A1 and those of the women in group A2(all P<0.05), but which of the women had no significant differences between group A1 and group A2(P>0.05). The values of INS0, INS60 and INS120 of the women in group A, in group A1, in group A2 and in group A3 were significantly higher than those of the women in group B(P<0.05),but there was no significant difference in the INS0value of the women among these groups(P>0.05).There was no significant difference in the INS60value of the women between group A2and group A3,but the INS60value of the women in group A2or in group A3was significantly higher than that of the women in group A1(P<0.05).The INS120value of the women in group A1,in group A2and in group A3had increased gradually(P<0.05).The HOMA-IR value of the women in group A3was significantly higher than that of the women in group A2,the HOMA-βvalue of the w

关 键 词：妊娠期糖尿病 糖耐量试验 血糖异常类型 胰岛素抵抗 风险 

分 类 号：R71[医药卫生—妇产科学]