不同糖耐量状态孕妇血清成纤维细胞生长因子21水平与胰岛β细胞功能的相关性研究

发布时间：2018-01-20 05:15

本文关键词： 成纤维生长因子(FGF) 糖尿病妊娠胰岛β细胞功能相关性　出处：《中国糖尿病杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨不同糖耐量状态孕妇血清成纤维细胞生长因子21(FGF21)水平与胰岛β细胞功能的关系。方法选取妊娠24~28周于我院接受50 g糖负荷试验(GCT)阳性的孕妇441例,1周后再行75 g OGTT,根据结果分为GDM组228例、妊娠期IGT(GIGT)组122例及妊娠期NGT(GNGT)组91名。ELISA检测血清FGF21水平,胰岛素抵抗指数(HOMA-IR),胰岛素敏感指数(Matsuda指数),胰岛β细胞功能指数(HOMA-β),第1、2时相胰岛素分泌指数及胰岛β细胞代偿胰岛素抵抗的分泌能力(ISSI)评估胰岛β细胞功能。FGF21与胰岛β细胞功能的相关性采用Pearson相关分析。结果 (1)GDM组和GIGT组BMI,0、1、2、3hPG及1、2、3 hIns均高于GNGT组和GIGT组(P0.05或P0.01)。GDM组SBP、DBP、0 hIns和HbA_1c高于GNGT组和GIGT组(P0.05或P0.01);(2)GNGT组、GIGT组及GDM组FGF21水平[(101.74±20.40)vs(137.93±25.52)vs(185.69±31.61)ng/L]和HOMA-IR依次升高[1.74(0.91,2.85)vs2.39(1.31,4.87)vs3.38(2.19,6.75)],Matsuda指数[(58.74±15.68)vs(41.62±15.65)vs(39.73±18.98)]和HOMA-β[(157.69±88.41)vs(144.35±78.98)vs(107.30±87.23)]及ISSI[(72253.55±15167.53)vs(42313.91±7112.47)vs(30032.50±11500.24)]依次降低(P0.05或P0.01)。GDM组第1、2时相胰岛素分泌指数低于GNGT组和GIGT组(P0.01),但GNGT组与GIGT组比较,差异无统计学意义(P0.05);(3)Pearson相关分析显示,FGF21与HOMA-IR呈正相关(r=0.255,P=0.030),与Matsuda指数、HOMA-β、第1、2时相胰岛素分泌指数及ISSI呈负相关(r=0.289、-0.256、-0.224、-0.230、-0.277,P=0.019、0.037、0.045、0.040、0.023)。结论随着糖代谢受损逐渐加重,FGF21水平升高,且与胰岛β细胞功能相关,可能与GDM的发生发展有关。
[Abstract]:Objective to study the serum fibroblast growth factor 21 (FGF21) in pregnant women with different glucose tolerance. Methods 441 pregnant women with 50 g glucose stress test (GCTs) positive were selected from 24 weeks after gestation. 75 g OGTT was given again one week later. According to the results, 228 cases were divided into GDM group. Serum FGF21 level and insulin resistance index (HOMA-IRR) were measured by Elisa in 122 cases of gestational IGT group and 91 cases of gestational NGT group. Insulin sensitivity index: Matsuda index, islet 尾 cell function index, HOMA- 尾, No. 1. 2:00 insulin secretion index and insulin compensatory insulin resistance of islet 尾 cells. The correlation between islet 尾 cell function, FGF21 and islet 尾 cell function was evaluated by Pearson correlation analysis. The levels of 3hPG and 3hPG and 1GDM were higher than those of GNGT group and GIGT group (P0.05 or P0.01U 路GDM group, P0.01U 路GDM group, P0.01U 路GDM group, P0.01U 路GDM group, P < 0.05). 0 hIns and HbA_1c were higher than those in GNGT and GIGT groups (P0.05 or P0.01). The level of FGF21 in GIGT group and GDM group. [101.74 卤20.40mv / L, 137.93 卤25.52VS / L, 185.69 卤31.61ng / L] and HOMA-IR increased in turn. [1.74 / 0.91 / 2.85 / vs2.39 / 1.31 / 4.87 / vs3.38 / 2.19 / 6.75)] Matsuda index. [Homa-尾 and HOMA- 尾, 41.62 卤15.65 VSD 39.73 卤18.98). [ISSI (157.69 卤88.41) and ISSI (144.35 卤78.98 vs 107.30 卤87.23). [72253.55 卤15167.53 VSD 42313.91 卤7112.47 vs1 30032.50 卤11500.24) (P < 0.05). P0.05 or P0.01GDM group 1. The insulin secretion index of 2:00 phase was lower than that of GNGT group and GIGT group, but there was no significant difference between GNGT group and GIGT group. Pearson correlation analysis showed that there was a positive correlation between FGF21 and HOMA-IR, and a positive correlation between FGF21 and HOMA-IR, and a positive correlation between FGF21 and Matsuda index (HOMA- 尾). There was a negative correlation between insulin secretion index and ISSI in the first and 2:00 phase. Conclusion the level of FGF21 increases gradually with impaired glucose metabolism, and is related to the function of islet 尾 cells. May be related to the occurrence and development of GDM.
【作者单位】：新乡市中心医院内分泌科;
【分类号】：R714.256
【正文快照】： GDM是指妊娠期间首次出现或发现的糖代谢准,即0 hPG、l hPG、2 hPG及3 hPG分别为5.3异常,发病率为2.31%?4.30%[〗]。研究[2]发现,mmol/L、10.0 mmol/L、8.6 mmol/L及7.8 mmol/L。GDM与T2DM具有相似的病理生理基础,均与IR 根据结果分为GDM组228例(2个上述值)、妊娠及胰岛J3细

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