妊娠期糖尿病患者孕中晚期血清胰高血糖素样肽-1变化及其临床意义
发布时间：2018-11-01 18:51
【摘要】：第一部分年龄对妊娠期糖尿病发病风险影响的调查研究目的:调查分析孕妇年龄对妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的影响。方法:对21371例2007年-2015年在解放军第306医院妇产科分娩,且在妊娠24~32周行一步法75 g葡萄糖耐量试验(OGTT)的初产单活胎孕妇的年龄及糖代谢情况进行回顾性调查分析。根据OGTT结果将孕妇分为非妊娠期糖尿病组(NGDM组)和妊娠期糖尿病组(GDM组),评估怀孕年龄与OGTT血糖水平的关系及对GDM患病的影响。采用SPSS17.0进行统计学分析。结果:GDM患者2577例,其发病率为12.1%。GDM在~20岁、~25岁、~30岁、~35岁、~40岁及~45岁的发病率分别为0、5.1%、7.5%、13.5%、30.4%及68.5%。GDM组孕妇年龄(33.28±5.36)岁显著高于NGDM组孕妇的(29.67±3.58)岁(P0.05)。2007-2015年,GDM孕妇平均年龄由(32.57±5.52)岁增加至(34.57±4.95)岁。所有孕妇及NGDM组峰值年龄均在29岁,而GDM组峰值年龄在31岁。随妊娠年龄的增加,NGDM组和GDM组孕妇OGTT的0 min、60 min和120 min血糖均呈上升趋势。结论:近年来GDM患病率较高,孕妇年龄逐年增高是重要原因,同时,GDM在30岁以下孕妇中有较高患病比例值得密切关注。第二部分妊娠期糖尿病患者孕中晚期血清胰高血糖素样肽-1变化及其临床意义目的:探讨妊娠期糖尿病(GDM)患者孕中晚期血清胰高血糖素样肽-1(GLP-1)水平变化。方法:选择妊娠期糖尿病40例(年龄32.69±5.46岁,孕周24.18±1.83周)及正常糖耐量(NGT)孕妇42例(年龄30.45±2.72岁,孕周24.38±0.88周),测定孕24-28周行一步法75 g葡萄糖耐量试验(OGTT)过程中血清GLP-1水平,比较其变化,分析其与GDM患者病情的关系。采用SPSS 21.0进行统计学分析。结果:与NGT比较,GDM患者OGTT过程中各时间点(0min、30min、60min、120min)GLP-1水平较无显著变化,但GDM患者血清GLP-1水平峰值在120分钟,较NGT组60分钟峰值延后,30分钟胰岛素(INS)/GLP-1显著降低(38.37±32.77 vs 69.55±69.43,P0.05)。空腹GLP-1、GLP-1曲线下面积(AUCGLP-1)均与胰岛素曲线下面积(AUCINS)呈显著正相关(r=0.24,r=0.27,p0.05)。结论:GDM孕妇OGTT过程中GLP-1早期分泌可能存在相对不足。
[Abstract]:Part one: the influence of age on the risk of gestational diabetes mellitus objective: to investigate and analyze the influence of gestational age on gestational diabetes mellitus (gestational diabetes mellitus,GDM). Methods: the age and glucose metabolism of 21371 pregnant women who gave birth in the department of gynecology and obstetrics in the 306 Hospital of PLA from 2007 to 2015 were analyzed retrospectively. One step 75 g glucose tolerance test (OGTT) was performed in 2432 weeks of pregnancy. According to the results of OGTT, pregnant women were divided into non-gestational diabetes mellitus (NGDM) group and gestational diabetes mellitus (GDM) group. SPSS17.0 was used for statistical analysis. Results: the incidence of 12.1%.GDM in 2577 patients with GDM was 2577 years old. The incidence rates of 12.1%.GDM in the range of ~ 20 years, ~ 25 years, ~ 30 years, ~ 35 years, ~ 40 years and ~ 45 years old were 0.5.1and 7.5cm, respectively. The age of pregnant women in 30.4% and 68.5%.GDM group (33.28 卤5.36) was significantly higher than that in NGDM group (29.67 卤3.58) years (P0.05). The average age of GDM pregnant women increased from (32.57 卤5.52) years to (34.57 卤4.95) years old. The peak age of all pregnant women and NGDM group was 29 years old, while the peak age of GDM group was 31 years old. With the increase of gestational age, the blood glucose of 0 min,60 min and 120 min of OGTT in NGDM group and GDM group showed an increasing trend. Conclusion: the prevalence of GDM is relatively high in recent years, and the age of pregnant women is increasing year by year. At the same time, the higher prevalence rate of GDM in pregnant women under 30 years old deserves close attention. Part two changes of serum glucagon like peptidyl (Glucagon-like peptide 1) in patients with gestational diabetes mellitus (GDM) and its clinical significance objective: to investigate the changes of serum glucagon like peptide-1 (GLP-1) levels in (GDM) patients with gestational diabetes mellitus (GDM) in the middle and late trimester of gestational diabetes mellitus (GDM). Methods: forty pregnant women with gestational diabetes mellitus (age 32.69 卤5.46, gestational age 24.18 卤1.83 weeks) and 42 pregnant women with normal glucose tolerance (NGT) (30.45 卤2.72 years old, 24.38 卤0.88 weeks of gestational age) were selected. Serum GLP-1 levels were measured during 75 g glucose tolerance test (OGTT) at 24-28 weeks of gestation. The changes of serum GLP-1 levels were compared, and the relationship between serum GLP-1 levels and the condition of GDM patients was analyzed. SPSS 21.0 was used for statistical analysis. Results: compared with NGT, there was no significant change in GLP-1 level at different time points (0 min, 30 min, 60 min or 120 min) during OGTT in GDM patients, but the peak of serum GLP-1 level in GDM patients was 120min, which was delayed than that in NGT group. Insulin (INS) / GLP-1 decreased significantly (38.37 卤32.77 vs, 69.55 卤69.43 vs, P0.05). There was a significant positive correlation between the area under fasting GLP-1,GLP-1 curve (AUCGLP-1) and (AUCINS) under insulin curve (r = 0.24). Conclusion: the early secretion of GLP-1 may be deficient in OGTT of GDM pregnant women.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.256
本文编号：2304794
[Abstract]:Part one: the influence of age on the risk of gestational diabetes mellitus objective: to investigate and analyze the influence of gestational age on gestational diabetes mellitus (gestational diabetes mellitus,GDM). Methods: the age and glucose metabolism of 21371 pregnant women who gave birth in the department of gynecology and obstetrics in the 306 Hospital of PLA from 2007 to 2015 were analyzed retrospectively. One step 75 g glucose tolerance test (OGTT) was performed in 2432 weeks of pregnancy. According to the results of OGTT, pregnant women were divided into non-gestational diabetes mellitus (NGDM) group and gestational diabetes mellitus (GDM) group. SPSS17.0 was used for statistical analysis. Results: the incidence of 12.1%.GDM in 2577 patients with GDM was 2577 years old. The incidence rates of 12.1%.GDM in the range of ~ 20 years, ~ 25 years, ~ 30 years, ~ 35 years, ~ 40 years and ~ 45 years old were 0.5.1and 7.5cm, respectively. The age of pregnant women in 30.4% and 68.5%.GDM group (33.28 卤5.36) was significantly higher than that in NGDM group (29.67 卤3.58) years (P0.05). The average age of GDM pregnant women increased from (32.57 卤5.52) years to (34.57 卤4.95) years old. The peak age of all pregnant women and NGDM group was 29 years old, while the peak age of GDM group was 31 years old. With the increase of gestational age, the blood glucose of 0 min,60 min and 120 min of OGTT in NGDM group and GDM group showed an increasing trend. Conclusion: the prevalence of GDM is relatively high in recent years, and the age of pregnant women is increasing year by year. At the same time, the higher prevalence rate of GDM in pregnant women under 30 years old deserves close attention. Part two changes of serum glucagon like peptidyl (Glucagon-like peptide 1) in patients with gestational diabetes mellitus (GDM) and its clinical significance objective: to investigate the changes of serum glucagon like peptide-1 (GLP-1) levels in (GDM) patients with gestational diabetes mellitus (GDM) in the middle and late trimester of gestational diabetes mellitus (GDM). Methods: forty pregnant women with gestational diabetes mellitus (age 32.69 卤5.46, gestational age 24.18 卤1.83 weeks) and 42 pregnant women with normal glucose tolerance (NGT) (30.45 卤2.72 years old, 24.38 卤0.88 weeks of gestational age) were selected. Serum GLP-1 levels were measured during 75 g glucose tolerance test (OGTT) at 24-28 weeks of gestation. The changes of serum GLP-1 levels were compared, and the relationship between serum GLP-1 levels and the condition of GDM patients was analyzed. SPSS 21.0 was used for statistical analysis. Results: compared with NGT, there was no significant change in GLP-1 level at different time points (0 min, 30 min, 60 min or 120 min) during OGTT in GDM patients, but the peak of serum GLP-1 level in GDM patients was 120min, which was delayed than that in NGT group. Insulin (INS) / GLP-1 decreased significantly (38.37 卤32.77 vs, 69.55 卤69.43 vs, P0.05). There was a significant positive correlation between the area under fasting GLP-1,GLP-1 curve (AUCGLP-1) and (AUCINS) under insulin curve (r = 0.24). Conclusion: the early secretion of GLP-1 may be deficient in OGTT of GDM pregnant women.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.256
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