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目的:探讨血清性激素结合球蛋白(SHBG)水平与妊娠期糖尿病(GDM)胰岛素抵抗(IR)的关系。方法:选择2015年3月~2016年1月在我院收治的90例GDM孕妇为观察组,选择同期健康体检孕妇45例为对照组,采用化学发光法检测两组孕妇的SHBG、胰岛素(INS)、C肽和游离睾酮(FT),糖化血红蛋白仪检测糖化血红蛋白(HbA1c),生化分析仪检测空腹血糖(FBG),并计算胰岛素抵抗指数(HOMA-IR)和敏感性指数(ISI),分析两组孕妇各指标的关系及其与两指数的相关性。结果:观察组孕妇空腹及餐后2h、3h的INS水平高于对照组,差异有统计学意义(P<0.05)。观察组孕妇餐后1h和2h的C肽水平低于对照组,而餐后3h高于对照组,差异有统计学意义(P<0.05)。观察组孕妇SHBG水平、ISI低于对照组,而HOMA-IR、FT、FBG和HbA1c水平高于对照组,差异有统计学意义(P<0.05)。SHBG水平与FINS、C肽水平、HOMA-IR呈负相关,与ISI呈正相关,差异有统计学意义(P<0.05)。结论:GDM孕妇胰岛素抵抗性和敏感性下降,血清SHBG水平降低且与INS水平、IR及敏感性相关,检测血清SHBG水平有助于了解GDM孕妇IR情况。
Objective: To investigate the relationship between serum level of sex hormone binding globulin (SHBG) and gestational diabetes mellitus (GDM) insulin resistance (IR). Methods: Ninety pregnant women with GDM treated in our hospital from March 2015 to January 2016 were selected as the observation group. Forty-five pregnant women of the same period were selected as the control group. The levels of SHBG, insulin (INS ), C peptide and free testosterone (FT), HbA1c by HbA1c, fasting blood glucose (FBG) by biochemical analyzer and HOMA-IR and ISI The relationship between the indexes of two groups of pregnant women and their correlation with the two indices. Results: The levels of INS in observation group at fasting and postprandial 2h and 3h were significantly higher than those in control group (P <0.05). The levels of C-peptide in observation group 1h and 2h after meal were lower than those in control group, but were significantly higher than those in control group 3h after meal (P <0.05). The levels of SHBG in pregnant women in observation group were lower than those in control group, while the levels of HOMA-IR, FT, FBG and HbA1c in pregnant women were higher than those in control group (P <0.05). The level of SHBG was negatively correlated with FINS, C-peptide level and HOMA-IR, and positively correlated with ISI (P <0.05). Conclusion: GDM pregnant women with decreased insulin resistance and sensitivity, serum SHBG levels decreased and INS levels, IR and sensitivity related to detection of serum SHBG levels help to understand the GDM pregnant women IR.