Hornnes P J, Kühl C
Acta Endocrinol Suppl (Copenh). 1986;277:24-6.
In pregnancy the secretion of a number of gastro-enteropancreatic hormones is considerably altered. These changes might be involved in the gestational modification of gastrointestinal physiology. The enteral stimulation of insulin secretion (the incretin effect) is diminished in pregnancy--both when determined indirectly and when the gastric inhibitory polypeptide (GIP) response to glucose ingestion is considered. Whether this is important for the deterioration of glucose tolerance in pregnancy is uncertain. In gestational diabetics similar findings as in normal pregnant women were obtained except that the GIP response to glucose ingestion was smaller and the GIP response to lipid ingestion greater than in normal women. It is, however, unlikely that these differences are responsible for the development of gestational diabetes. Significant positive correlations were found between the increase of plasma cortisol levels during normal pregnancy and the concomitant decrease in glucose tolerance indicating that the increased cortisol levels might be involved in the development of the insulin resistance found in normal pregnancy.
在孕期，多种胃肠胰激素的分泌会发生显著变化。这些改变可能与胃肠道生理功能的妊娠性改变有关。孕期肠内刺激胰岛素分泌（肠促胰岛素效应）减弱——无论是间接测定还是考虑胃抑制性多肽（GIP）对葡萄糖摄入的反应时均如此。这对孕期糖耐量恶化是否重要尚不确定。在妊娠糖尿病患者中，除了GIP对葡萄糖摄入的反应比正常女性小、对脂质摄入的反应比正常女性大之外，得到了与正常孕妇相似的结果。然而，这些差异不太可能是妊娠糖尿病发生的原因。在正常孕期发现血浆皮质醇水平升高与同时出现的糖耐量降低之间存在显著正相关，这表明皮质醇水平升高可能与正常孕期出现的胰岛素抵抗的发生有关。
