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根据妊娠期糖尿病孕妇的特征探讨脂肪因子与胰岛素抵抗的关系

Adipokines and Insulin Resistance According to Characteristics of Pregnant Women with Gestational Diabetes Mellitus.

作者信息

Jeon Eon Ju, Hong Seong Yeon, Lee Ji Hyun

机构信息

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.

出版信息

Diabetes Metab J. 2017 Dec;41(6):457-465. doi: 10.4093/dmj.2017.41.6.457. Epub 2017 Nov 15.

Abstract

BACKGROUND

The aim of this study was to evaluate adipokines concentration and insulin resistance according to maternal age or obesity at pregnancy and weight change at diagnosed gestational diabetes mellitus (GDM) in pregnant women with GDM.

METHODS

This study included 57 pregnant women who were diagnosed with GDM at 24 to 28 weeks of gestation. The subjects were classified into two or three groups according to pre-pregnancy body mass index (BMI, <25 kg/m² vs. ≥25 kg/m²), maternal age at pregnancy (<35 years old vs. ≥35 years old), and weight change during pregnancy at screening for GDM (weight change below, within, and in excess of the recommended range). They were respectively compared in each group.

RESULTS

Leptin, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA2-%B were increased in the group with pre-pregnancy BMI ≥25 kg/m². Leptin and HOMA-IR were positively correlated with BMI both before pregnancy and at screening for GDM. There were no significant correlations between HOMA-IR and adipokines. HOMA-IR showed positive correlation with HOMA2-%B and negative correlation with HOMA2-%S.

CONCLUSION

Leptin and HOMA-IR at diagnosed GDM were increased in the GDM patients with obesity before pregnancy. They were positively correlated with BMI both before pregnancy and at screening for GDM. The effect of maternal age at pregnancy and weight change during pregnancy at GDM screening on adipokines and insulin resistance might be less pronounced than the effect of maternal obesity.

摘要

背景

本研究旨在根据妊娠时的孕妇年龄或肥胖情况以及妊娠糖尿病(GDM)确诊时的体重变化,评估患有GDM的孕妇体内脂肪因子浓度和胰岛素抵抗情况。

方法

本研究纳入了57例在妊娠24至28周时被诊断为GDM的孕妇。根据孕前体重指数(BMI,<25 kg/m² 与≥25 kg/m²)、妊娠时的孕妇年龄(<35岁与≥35岁)以及GDM筛查时孕期体重变化(体重变化低于、处于和超过推荐范围),将研究对象分为两组或三组。对每组分别进行比较。

结果

孕前BMI≥25 kg/m²组的瘦素、胰岛素抵抗稳态模型评估(HOMA-IR)和HOMA2-%B升高。瘦素和HOMA-IR在孕前和GDM筛查时均与BMI呈正相关。HOMA-IR与脂肪因子之间无显著相关性。HOMA-IR与HOMA2-%B呈正相关,与HOMA2-%S呈负相关。

结论

孕前肥胖的GDM患者在GDM确诊时瘦素和HOMA-IR升高。它们在孕前和GDM筛查时均与BMI呈正相关。妊娠时的孕妇年龄和GDM筛查时孕期体重变化对脂肪因子和胰岛素抵抗的影响可能不如孕妇肥胖的影响明显。

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