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目的探讨孕妇血浆抵抗素在妊娠期糖尿病(GDM)发病机制中的可能作用。方法将90例分为3组:GDM组(30例)、IGT组(30例)、NGT组(30例)。进行葡萄糖耐量试验(OGTT)、胰岛素释放试验,同时检测血浆抵抗素。利用稳态模型胰岛素抵抗指数(HOMA-IRI)及胰岛分泌功能指数(HBCI)来评价胰岛素抵抗程度及胰岛β细胞功能,分析血浆抵抗素与胰岛素抵抗指数及分泌指数之间的关系。结果①GDM组HOMA-IRI最高、HBCI最低;②GDM组血浆抵抗素水平高于IGT组(P<0.01)和NGT组(P<0.01),但IGT组与NGT组之间比较无显著差异性;③相关性分析表明:GDM血浆抵抗素与FPG、FINS、HOMA-IRI呈正相关。结论①GDM患者存在胰岛素抵抗素,同时存在胰岛β细胞分泌功能减低,与成人2型糖尿病相似。②抵抗素与IR关系密切,提示抵抗素与GDM发病有关。
Objective To investigate the possible role of plasma resistin in the pathogenesis of gestational diabetes mellitus (GDM). Methods 90 cases were divided into 3 groups: GDM group (30 cases), IGT group (30 cases) and NGT group (30 cases). Glucose tolerance test (OGTT), insulin release test, and plasma resistin were also performed. The homeostasis model insulin resistance index (HOMA-IRI) and islet secretion function index (HBCI) were used to assess the degree of insulin resistance and pancreatic β-cell function, and the relationship between plasma resistin and insulin resistance index and secretion index was analyzed. Results ① The HOMA-IRI was the highest in GDM group and the lowest in HBCI group. ② The level of plasma resistin in GDM group was higher than that in IGT group and NGT group (P <0.01), but there was no significant difference between IGT group and NGT group. Correlation analysis showed that there was a positive correlation between GDM plasma resistin and FPG, FINS and HOMA-IRI. Conclusion ① There is insulin resistance in GDM patients, and at the same time, the secretion of pancreatic β-cells is reduced, which is similar to that of type 2 diabetes in adults. ② resistin and IR are closely related, suggesting that the resistance and GDM pathogenesis.