摘要
选取妊娠中期（24—28周）女性55例，根据口服葡萄糖耐量试验（OGTT）结果，分为妊娠糖尿病组（25例）及正常糖耐量组（30名）。妊娠糖尿病组年龄高于正常糖耐量组，各点血糖和各点胰岛素、OGTT血糖曲线下面积（AUC葡萄糖）、胰岛素曲线下面积（AUC胰岛素）、基础胰岛素分泌功能指数（HOMA—p）均高于正常糖耐量组（P〈0．05），而胰岛素敏感性指数（ISI—Matsuda）、动态胰岛素分泌指数（Stumvoll 1相、2相指数）、胰岛素分泌敏感指数（ISSI）较正常糖耐量组降低（P〈0．05），AUC胰岛素／AUC葡萄糖降低明显（P〈0．01）。各点胰升糖素及胰升糖素曲线下面积（AUC胰升糖素）在妊娠糖尿病组与正常糖耐量组差异无统计学意义（P〉0．05）。多元线性回归分析表明，ISI—Matsuda、HOMA-β及Stumvoll 1相、2相指数、ISSI均可解释部分血糖变化．其中ISI—Matsuda对血糖变化的贡献最大。妊娠糖尿病患者胰岛仪细胞功能正常，B细胞功能减退．胰岛素分泌不能代偿胰岛素抵抗是导致妊娠糖尿病发生最主要的原因。
Based on the resuh of oral 75 g glucose tolerance test （ OGTr）, 55 pregnant women during the second trimester （ gestational age 24-28 weeks） were selected and divided into gestational diabetes mellitus （ GDM ） group （ n = 25 ） and normal glucose tolerance （NGT） group （ n = 30）. Women with GDM were older than those in NGT group. Blood glucose and insulin levels during the OGTr, incremental area under the glucose curve （ AUCGLU ） and insulin curve （ AUCjNs ） during the OGTT, and basic insulin secretion index （HOMA-β） in the GDM group were higher compared with those in NGT group （P〈0.05）. However, in GDM group, insulin sensitivity index （ISI-Matsuda）, dynamic insulin secretion index （ Stumvoll 1- and 2-phase insulin secretion indices ） , and insulin secretion-sensitivity index （ISSI） were lowered （all P 〈 0.05 ）, so was AUC INS/AUCcLU （P 〈 0. 01 ）, as compared with those in NGT group. Blood glucagon levels during OGTT and incremental area under the glucagon curve （ AUC CL ） showed no significant differences between 2 groups （ P〉 0.05 ）. Multiple linear regression analysis showed that ISI-Matsuda, ISSI, HOMA-15, Stumvoll 1 - and 2-phase insulin secretion indices accounted partially for the change of plasma glucose and ISI-Matsuda was the most important one among them. The function of islet α-cell seems to be normal while the function of ^-cell is impaired in the patients with GDM, and failure of insulin secretion to overcome insulin resistance is the main reason for GDM.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2012年第10期835-838,共4页
Chinese Journal of Endocrinology and Metabolism
关键词
糖尿病
妊娠
胰岛素抵抗
α细胞功能
Β细胞功能
Diabetes mellitus, gestational
Insulin resistance
c^-cell function
α-cell function
