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妊娠期糖尿病及产后的胰岛素敏感性和抵抗素水平

Insulin sensitivity and resistin levels in gestational diabetes mellitus and after parturition.

作者信息

Megia Ana, Vendrell Joan, Gutierrez Cristina, Sabaté Modest, Broch Montse, Fernández-Real José-Manuel, Simón Inmaculada

机构信息

Endocrinology and Diabetes Research Department, University Hospital of Tarragona Joan XXIII, Pere Virgili Institute, Rovira i Virgili University, 43007, Tarragona, Spain.

出版信息

Eur J Endocrinol. 2008 Feb;158(2):173-8. doi: 10.1530/EJE-07-0671.

Abstract

CONTEXT

Resistin is expressed and secreted by the placenta during pregnancy. Increased serum resistin levels have been found in the second half of normal pregnancy, but its role in the pathogenesis of the insulin resistance of pregnancy is undetermined.

OBJECTIVE

The objective of the study was to assess the relationship between circulating resistin levels and insulin sensitivity in gestational diabetes mellitus (GDM).

DESIGN AND SETTING

A case (n=23)-control (n=35) study was performed at the obstetrics and endocrinology clinic of a university hospital.

PATIENTS

In total, 58 Caucasian women with a singleton pregnancy who had been referred for a 100 g oral glucose tolerance test were enrolled between the weeks 26 and 30, and 22 women with GDM were also evaluated after pregnancy.

MAIN OUTCOME MEASURES

Serum resistin and insulin sensitivity in GDM during and after pregnancy. The relationship of resistin to metabolic abnormalities was evaluated.

RESULTS

Resistin levels were lower in GDM women than in pregnant women with normal glucose tolerance (NGT) (4.32+/-1.56 vs 9.30+/-1.32 ng/ml, P<0.001), and experienced a further decrease after parturition (4.24+/-1.56 vs 3.11+/-1.63 ng/ml, P=0.003). The association between low serum resistin levels and the diagnosis of GDM was independent of the degree of insulin sensitivity.

CONCLUSION

Lower resistin levels were observed in GDM than in NGT women and decreased after parturition, suggesting a role for resistin in the development of this disease. But we have failed to find an independent relationship between resistin levels and insulin sensitivity during pregnancy.

摘要

背景

孕期胎盘可表达并分泌抵抗素。正常妊娠后半期血清抵抗素水平升高,但其在妊娠胰岛素抵抗发病机制中的作用尚不确定。

目的

本研究旨在评估妊娠期糖尿病(GDM)患者循环抵抗素水平与胰岛素敏感性之间的关系。

设计与地点

在一所大学医院的妇产科和内分泌科门诊进行了一项病例(n = 23)对照(n = 35)研究。

患者

共有58例白人单胎妊娠妇女在孕26至30周期间被转诊进行100 g口服葡萄糖耐量试验,并纳入研究,另外22例GDM妇女在产后也进行了评估。

主要观察指标

GDM患者孕期及产后的血清抵抗素和胰岛素敏感性。评估抵抗素与代谢异常之间的关系。

结果

GDM患者的抵抗素水平低于糖耐量正常(NGT)的孕妇(4.32±1.56 vs 9.30±1.32 ng/ml,P<0.001),产后进一步下降(4.24±1.56 vs 3.11±1.63 ng/ml,P = 0.003)。低血清抵抗素水平与GDM诊断之间的关联独立于胰岛素敏感性程度。

结论

GDM患者的抵抗素水平低于NGT妇女,且产后下降,提示抵抗素在该疾病的发生中起作用。但我们未能发现孕期抵抗素水平与胰岛素敏感性之间存在独立关系。

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