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患有和未患有妊娠期糖尿病的女性在口服葡萄糖耐量试验期间的胰岛素抵抗和血脂情况。

Insulin resistance and lipid profile during an oral glucose tolerance test in women with and without gestational diabetes mellitus.

作者信息

Liang Zx, Wu Y, Zhu Xy, Fang Q, Chen Dq

机构信息

a Obstetrical Department, Women's Hospital , School of Medicine, Zhejiang University , Hangzhou , China.

出版信息

J Obstet Gynaecol. 2016;36(3):337-9. doi: 10.3109/01443615.2015.1060197. Epub 2015 Oct 14.

Abstract

We aimed to compare changes in insulin levels during an oral glucose tolerance test (OGTT) between women with normal glucose tolerance (NGT) during pregnancy and those with gestational diabetes mellitus (GDM). Overall, 105 pregnant women between 24 and 28 weeks' gestation, 50 with NGT and 55 with GDM according to NDDG standard, were enrolled into the study. The levels of fasting blood glucose, insulin, triglyceride (TG) and total cholesterol (TC) and the insulin levels, blood glucose levels at 1, 2 and 3 hours post oral glucose administration during an OGTT (5.8, 10.6, 9.2 and 8.1 mmol/L, respectively) were measured. Then, insulin resistance (IR) index was calculated. There was no significant difference in fasting, 3-h insulin levels and 3-h blood glucose levels between those with NGT and those with GDM (P > 0.05). However, 1-h and 2-h insulin levels, fasting and 1-h and 2-h blood glucose levels in women with GDM were significantly higher than those in the NGT group (P < 0.05). Fasting TC and TG levels in the GDM group were significantly higher than those with NGT (P = 0.031 and P = 0.025, respectively). Correlation analysis showed that TG and TC levels were positively correlated with homoeostasis model assessment-IR (HOMA-IR) (r = 0.67 and r = 0.78, respectively; P < 0.05). Our findings suggest that insulin sensitivity in women with GDM was significantly lower than that observed in those with NGT. Reducing IR and blood lipids in women with GDM could potentially improve maternal and foetal outcomes.

摘要

我们旨在比较孕期糖耐量正常(NGT)的女性与妊娠期糖尿病(GDM)女性在口服葡萄糖耐量试验(OGTT)期间胰岛素水平的变化。总体而言,根据美国国家糖尿病数据组(NDDG)标准,选取了105名妊娠24至28周的孕妇,其中50名糖耐量正常,55名患有妊娠期糖尿病,纳入本研究。测量了空腹血糖、胰岛素、甘油三酯(TG)和总胆固醇(TC)水平,以及OGTT期间口服葡萄糖后1、2和3小时的胰岛素水平、血糖水平(分别为5.8、10.6、9.2和8.1 mmol/L)。然后,计算胰岛素抵抗(IR)指数。NGT组和GDM组在空腹、3小时胰岛素水平和3小时血糖水平方面无显著差异(P>0.05)。然而,GDM组女性的1小时和2小时胰岛素水平、空腹以及1小时和2小时血糖水平显著高于NGT组(P<0.05)。GDM组的空腹TC和TG水平显著高于NGT组(分别为P = 0.031和P = 0.025)。相关性分析表明,TG和TC水平与稳态模型评估-IR(HOMA-IR)呈正相关(r分别为0.67和0.78;P<0.05)。我们的研究结果表明,GDM女性的胰岛素敏感性显著低于NGT女性。降低GDM女性的IR和血脂可能会改善母婴结局。

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