孕期不同糖代谢状态下骨钙素及脂联素与胰岛素抵抗的相关性分析
发布时间：2019-05-18 00:14
【摘要】：目的:该课题通过观察孕期女性在不同糖代谢状态下血清骨钙素及脂联素水平的变化,探讨妊娠期糖尿病的可能发病机制,有望为未来防治2型糖尿病提供新的理论依据。方法:参照2013年ADA糖尿病诊疗指南,依据孕期24-28周(PGDM组除外)口服葡萄糖耐量试验(OGTT)结果:将28名孕妇纳入糖尿病合并妊娠(PGDM)组,42名孕妇纳入妊娠糖尿病(GDM)组,30名孕妇纳入糖耐量正常(NGT)组。检测血糖、胰岛素、脂联素(ADP)、骨钙素(OC),计算胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β),统计数据后进行相关性分析。结果:1.年龄、血脂四项指标及孕周差异三组间均无统计学意义(P0.05),组间妊娠前BMI及孕期BMI增加差值差异均无统计学意义(P0.05);2.PGDM组、GDM组、NGT组FPG、OGTT 2小时血糖(2 hPG)及HbA1c呈递减趋势,组间比较差异均有统计学意义(均P0.01);3.PGDM组FINS、HOMA-IR显著高于GDM组及NGT组(P0.01),NGT组FINS、HOMA-IR均低于GDM组,差异有统计学意义(P0.05);4.PGDM组、GDM组、NGT组HOMA-β呈递增趋势,组间比较差异有统计学意义(P0.01);5.GDM组、NGT组血清OC水平均高于PGDM组(分别P0.01、P0.05),GDM组血清OC水平高于NGT组,差异均有统计学意义(P0.01);6.血清ADP水平NGT组、GDM组、PGDM组依次降低,组间比较差异均有统计学意义(均P0.01);7.Pearson相关分析结果:GDM及NGT组血清OC与FINS、HOMA-IR显著正相关,相关系数分别为0.709、0.696(P0.01);PGDM组血清OC与FINS,HOMA-IR呈负相关,相关系数为-0.707、-0.784(P0.01);三组ADP与HOMA-IR显著负相关,相关系数为-0.473(P0.01);三组ADP与OC无明显相关性。结论:1.PGDM组、GDM组及NGT组FINS、HOMA-IR依次降低,提示妊娠期妇女随着糖代谢异常的加重,胰岛素抵抗更为明显;2.妊娠期不同糖代谢状态下妇女血清ADP与HOMA-IR呈负相关,NGT组、GDM组、PGDM组ADP水平依次降低,提示血清ADP降低可能促发了胰岛素抵抗,进而导致糖代谢异常;3.GDM组、NGT组血清OC水平均高于PGDM组,GDM组血清OC水平高于NGT组,GDM组、NGT组血清OC与HOMA-IR正相关,PGDM组血清OC与HOMA-IR负相关,推测血清OC水平升高可能是对早期胰岛素抵抗的一种代偿,随着胰岛素抵抗的加重及血糖持续升高而出现了失代偿。
[Abstract]:Objective: to observe the changes of serum osteocalcin and adiponectin levels in pregnant women under different glucose metabolism conditions, and to explore the possible pathogenesis of gestational diabetes mellitus (GDM), which is expected to provide a new theoretical basis for the prevention and treatment of type 2 diabetes mellitus (T2DM) in the future. Methods: according to the guidelines for the diagnosis and treatment of ADA diabetes mellitus in 2013, according to the (OGTT) results of oral glucose tolerance test at 24 weeks of pregnancy (except PGDM group): 28 pregnant women were included in the (PGDM) group of diabetes mellitus complicated with pregnancy. 42 pregnant women were included in gestational diabetes mellitus (GDM) group and 30 pregnant women in normal glucose tolerance (NGT) group. Insulin resistance index (HOMA-IR) and islet 尾 cell function index (HOMA- 尾) were calculated by measuring blood glucose, insulin and adiponectin (ADP), osteocalcin (OC),. Result: 1. There was no significant difference in age, blood lipid and gestational age among the three groups (P 0.05), but there was no significant difference in BMI and BMI before pregnancy between the three groups (P 0.05). FPG,OGTT 2-hour blood glucose (2 hPG) and HbA1c in 2.PGDM group, GDM group and NGT group showed a decreasing trend, and the differences between the two groups were statistically significant (all P 0.01). FINS,HOMA-IR in 3.PGDM group was significantly higher than that in GDM group and NGT group (P 0.01. FINS,HOMA-IR in), NGT group was lower than that in GDM group, the difference was statistically significant (P 0.05). There was an increasing trend of HOMA- 尾 in 4.PGDM group, GDM group and NGT group, and there was significant difference between the two groups (P 0.01). The level of serum OC in 5.GDM group and NGT group was higher than that in PGDM group (P0.01, P 0.05), and the level of serum OC in), GDM group was significantly higher than that in NGT group (P 0.01). The level of serum ADP in NGT group, GDM group and PGDM group decreased in turn, and the difference between the two groups was statistically significant (all P 0.01). The results of 7.Pearson correlation analysis showed that there was a significant positive correlation between serum OC and FINS,HOMA-IR in GDM and NGT groups, and the correlation coefficients were 0.709 and 0.696 (P 0.01), respectively. There was a negative correlation between serum OC and FINS,HOMA-IR in PGDM group, with a correlation coefficient of-0.707, 鈮，
本文编号：2479514
[Abstract]:Objective: to observe the changes of serum osteocalcin and adiponectin levels in pregnant women under different glucose metabolism conditions, and to explore the possible pathogenesis of gestational diabetes mellitus (GDM), which is expected to provide a new theoretical basis for the prevention and treatment of type 2 diabetes mellitus (T2DM) in the future. Methods: according to the guidelines for the diagnosis and treatment of ADA diabetes mellitus in 2013, according to the (OGTT) results of oral glucose tolerance test at 24 weeks of pregnancy (except PGDM group): 28 pregnant women were included in the (PGDM) group of diabetes mellitus complicated with pregnancy. 42 pregnant women were included in gestational diabetes mellitus (GDM) group and 30 pregnant women in normal glucose tolerance (NGT) group. Insulin resistance index (HOMA-IR) and islet 尾 cell function index (HOMA- 尾) were calculated by measuring blood glucose, insulin and adiponectin (ADP), osteocalcin (OC),. Result: 1. There was no significant difference in age, blood lipid and gestational age among the three groups (P 0.05), but there was no significant difference in BMI and BMI before pregnancy between the three groups (P 0.05). FPG,OGTT 2-hour blood glucose (2 hPG) and HbA1c in 2.PGDM group, GDM group and NGT group showed a decreasing trend, and the differences between the two groups were statistically significant (all P 0.01). FINS,HOMA-IR in 3.PGDM group was significantly higher than that in GDM group and NGT group (P 0.01. FINS,HOMA-IR in), NGT group was lower than that in GDM group, the difference was statistically significant (P 0.05). There was an increasing trend of HOMA- 尾 in 4.PGDM group, GDM group and NGT group, and there was significant difference between the two groups (P 0.01). The level of serum OC in 5.GDM group and NGT group was higher than that in PGDM group (P0.01, P 0.05), and the level of serum OC in), GDM group was significantly higher than that in NGT group (P 0.01). The level of serum ADP in NGT group, GDM group and PGDM group decreased in turn, and the difference between the two groups was statistically significant (all P 0.01). The results of 7.Pearson correlation analysis showed that there was a significant positive correlation between serum OC and FINS,HOMA-IR in GDM and NGT groups, and the correlation coefficients were 0.709 and 0.696 (P 0.01), respectively. There was a negative correlation between serum OC and FINS,HOMA-IR in PGDM group, with a correlation coefficient of-0.707, 鈮，
本文编号：2479514
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