妊娠糖尿病患者孕中晚期血清GLP-1水平变化及临床意义

发布时间：2018-07-13 20:44

【摘要】：目的探讨妊娠糖尿病(GDM)患者孕中晚期血清胰高血糖素样肽1(GLP-1)水平变化及临床意义。方法选取规律产检孕妇82例,其中GDM患者40例(GDM组),糖耐量正常者42例(对照组)。两组均于孕24~28周行75 g口服葡萄糖耐量试验(OGTT),分别于糖负荷后0、30、60、120 min时检测血清GLP-1及GLP-1曲线下面积(AUCGLP-1),分别计算糖负荷后0、30、60、120 min时胰岛素(INS)/GLP-1及胰岛素曲线下面积(AUCINS)/AUCGLP-1。分析GDM患者血清GLP-1、AUCGLP-1与血糖(GLU)、血糖曲线下面积(AUCGLU)、INS及AUCINS的相关性。结果 GDM组糖负荷后30 min时INS/GLP-1低于对照组(P0.05),两组各时间点血清GLP-1水平及AUCGLP-1、AUCINS/AUCGLP-1比较差异均无统计学意义(P均0.05)。GDM患者血清GLP-1与糖负荷后0、30、60、120 min时GLU、INS及AUCGLU均不相关(P均0.05),GLP-1及AUCGLP-1均与AUCINS呈正相关(r分别为0.243、0.270,P均0.05),糖负荷后60、120 min时AUCGLP-1与INS呈正相关(r分别为0.013、0.041,P均0.05)。结论与糖耐量正常孕妇相比,GDM患者血清GLP-1水平存在峰值延后倾向,在75 g OGTT糖负荷后30 min可能存在GLP-1分泌相对不足,提示GDM患者可能存在GLP-1抵抗。
[Abstract]:Objective to investigate the changes and clinical significance of serum glucagon-like peptide 1 (GLP-1) levels in patients with gestational diabetes mellitus (GDM). Methods 82 pregnant women with regular birth examination were selected, including 40 patients with GDM (GDM group) and 42 patients with normal glucose tolerance (control group). 75 g oral glucose tolerance test (OGTT) was performed at the 28th week of gestation. Serum GLP-1 and the area under the GLP-1 curve (AUCGLP-1) were measured at 60120 min after glucose loading. The insulin (ins) -GLP-1 and the area under insulin curve (AUCINS) were calculated respectively at 60120 min after glucose loading. To analyze the correlation between serum GLP-1AUCGLP-1 and blood glucose (GLU), area under blood glucose curve (AUCGLU), ins and AUCINS in patients with GDM. Results the levels of serum GLP-1 and AUCGLP-1 at 30 min after glucose load in GDM group were significantly lower than those in control group (P0.05). There was no significant difference in serum GLP-1 and AUCGLP-1AUCINS / AUCGLP-1 between the two groups at 30 min after glucose load (P0.05). There was no significant difference between GLP-1 and AUCGLU in serum GLP-1 and AUCGLU in GDM patients at 0 3060120 min after glucose load (P 0.05). There was a positive correlation between AUCGLP-1 and AUCINS (r = 0.243 0. 270, P 0. 05), and a positive correlation between AUCGLP-1 and ins at 60120 min after glucose loading (r = 0. 013, 0. 041, P < 0. 05). Conclusion compared with normal glucose tolerance pregnant women, serum GLP-1 levels in GDM patients tend to be delayed, and GLP-1 secretion may be insufficient at 30 min after glucose loading of 75 g OGTT, suggesting that GLP-1 resistance may exist in GDM patients.
【作者单位】：安徽医科大学解放军306临床学院;德州市人民医院;
【基金】：国家自然科学基金资助项目(21331001) 国家科技重大专项子课题(2011ZX09307-001-08) 北京市科技计划(Z161100000516010) 北京市自然科学基金资助项目(7122109)
【分类号】：R714.256

【相似文献】