Catalano P M, Bernstein I M, Wolfe R R, Srikanta S, Tyzbir E, Sims E A
Am J Obstet Gynecol. 1986 Dec;155(6):1255-62. doi: 10.1016/0002-9378(86)90155-9.
To investigate whether there are subclinical abnormalities of glucose metabolism in women with previous gestational diabetes that are consistent with a high incidence of diabetes mellitus in later life, eight patients with previous gestational diabetes and normal oral glucose tolerance were evaluated by means of body composition studies, intravenous glucose tolerance tests, and the hyperinsulinemic-euglycemic clamp coupled with 6-6 dideuterated glucose infusion, indirect calorimetry, and measurement of islet cell antibodies. Eight control subjects were matched for percent body fat and diet and studied in a similar fashion. Abnormalities of insulin response and insulin resistance were present in four (50%) of patients with previous gestational diabetes. Insulin resistance was significantly greater in the patients than in the control subjects. When compared with lean patients, obese patients with previous gestational diabetes had significantly greater insulin response to the intravenous glucose tolerance test and insulin resistance. These changes are consistent with reported findings of an early and progressive development of overt diabetes in patients who had gestational diabetes.
为了研究既往有妊娠期糖尿病的女性是否存在糖代谢亚临床异常，这些异常与日后糖尿病的高发病率相符，我们对8例既往有妊娠期糖尿病且口服葡萄糖耐量正常的患者进行了身体成分研究、静脉葡萄糖耐量试验、高胰岛素-正常血糖钳夹试验（同时输注6-6-二氘代葡萄糖）、间接测热法以及胰岛细胞抗体检测。选取8名身体脂肪百分比和饮食相匹配的对照受试者，以类似方式进行研究。4例（50%）既往有妊娠期糖尿病的患者存在胰岛素反应和胰岛素抵抗异常。患者的胰岛素抵抗明显高于对照受试者。与体型瘦的患者相比，既往有妊娠期糖尿病的肥胖患者对静脉葡萄糖耐量试验的胰岛素反应和胰岛素抵抗明显更高。这些变化与既往报道的妊娠期糖尿病患者早期及逐渐发展为显性糖尿病的研究结果一致。
