Narayanan Niya, Sahoo Jayaprakash, Kamalanathan Sadishkumar, Sagili Haritha, Zachariah Bobby, Naik Dukhabandhu, Roy Ayan, Merugu Chandhana
Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India.
Department of Obstetrics and Gynaecology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India.
Indian J Endocrinol Metab. 2024 Jan-Feb;28(1):71-79. doi: 10.4103/ijem.ijem_7_23. Epub 2024 Feb 26.
The aim of this study was to compare insulin sensitivity, islet cell function, and incretin axes in pregnant subjects with GDM and normal healthy controls.
Pregnant women at 24 to 28 weeks of gestation were subjected to a 75 g oral glucose tolerance test (OGTT). Samples for glucose, insulin, glucagon, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were collected at 0, 30, 60, and 120 min during the OGTT. The Matsuda index (MI) and insulin secretion and sensitivity index-2 (ISSI-2) were assessed. The glucagon suppression index (GSI) was calculated along with the area under the curve (AUC) for glucose, insulin, glucagon, GLP-1, and GIP.
A total of 48 pregnant women (25 GDM and 23 controls) were finally analysed. The MI and ISSI-2 were low in the GDM group [4.31 vs. 5.42; = 0.04], [1.99 vs. 3.18, ≤ 0.01] respectively). Total AUC was higher in the GDM group (7411.7 vs. 6320.1, = 0.02). GSI was significantly lower in the GDM group (-62.6 vs. -24.7, = 0.03). Fasting GLP-1 levels were low in GDM women (17.3 vs. 22.2, = 0.04). The total AUC positively correlated with total GSI in the GDM group.
Asian-Indian GDM women have high insulin insensitivity, islet cell dysfunction, and low fasting GLP-1. Incretin axis dysfunction plays a potential role in their islet cell dysfunction.
本研究旨在比较患有妊娠期糖尿病（GDM）的孕妇与正常健康对照者的胰岛素敏感性、胰岛细胞功能和肠促胰岛素轴。
对妊娠24至28周的孕妇进行75克口服葡萄糖耐量试验（OGTT）。在OGTT期间的0、30、60和120分钟采集葡萄糖、胰岛素、胰高血糖素、胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）的样本。评估松田指数（MI）以及胰岛素分泌和敏感性指数-2（ISSI-2）。计算胰高血糖素抑制指数（GSI）以及葡萄糖、胰岛素、胰高血糖素、GLP-1和GIP的曲线下面积（AUC）。
最终共分析了48名孕妇（25名GDM患者和23名对照者）。GDM组的MI和ISSI-2较低[分别为4.31对5.42；P = 0.04]，[1.99对3.18，P≤0.01]。GDM组的总AUC较高（7411.7对6320.1，P = 0.02）。GDM组的GSI显著较低（-62.6对-24.7，P = 0.03）。GDM女性的空腹GLP-1水平较低（17.3对22.2，P = 0.04）。GDM组中总AUC与总GSI呈正相关。
亚洲印度裔GDM女性存在高胰岛素抵抗、胰岛细胞功能障碍以及空腹GLP-1水平低的情况。肠促胰岛素轴功能障碍在其胰岛细胞功能障碍中起潜在作用。
