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胰岛素抵抗揭秘:妊娠期糖尿病中的激素相关性

Insulin resistance unraveled: Hormonal correlations in gestational diabetes.

作者信息

Chen Siyu, Bai Xuru, Yin Xuerui, Bai Lan

机构信息

The First People's Hospital of Chengdu Shuangliu District /Sichuan University West China Airport Hospital, Department of Clinical Laboratory, Chengdu, Sichuan, China.

出版信息

J Med Biochem. 2024 Nov 16;43(6):835-842. doi: 10.5937/jomb0-49981.

Abstract

BACKGROUND

To investigate the correlation between the variations of cortisol and insulin-like growth factor 1 (IGF1) and sex hormone binding globulin (SHBG) levels with insulin resistance and glucolipid metabolism in gestational glucose diabetics.

METHODS

The study included 110 pregnant women diagnosed with gestational diabetes mellitus in the GDM group, and 130 healthy pregnant women in the control group. Data collection, examination of relevant indexes, and comparison of differences in indexes between groups were conducted. Pearson correlation analysis was utilized to identify risk variables associated with GDM development, while binary logistic regression was employed to determine risk factors for GDM development.

RESULTS

The GDM group showed significantly greater levels of FPG, HbA1c, FINS, TG, FFA, Lp-PLA2, HOMA-IR, Cortisol, and IGF-1 compared to the control group (P<0.05), but considerably lower levels of SHBG, and HOMA-β. HOMA-IR was found to be positively correlated with FPG, HbA1c, FINS, TG, FFA, Lp-PLA2, Cortisol and IGF-1, whereas, negatively correlated with SHBG. FINS and SHBG were found to be independent protective factors for GDM (OR=0.463, 0.801, P<0.05), whereas, HbA1c, TG, FFA, and gestational BMI were found to be independent risk factors for GDM (OR=1.992, 4.234, 1.990, 1.629, P<0.05).

CONCLUSIONS

SHBG, IGF-1, and Cortisol are all linked to glucose-lipid metabolism indices, and aberrant serum hormone expression is a major contributor to insulin resistance.

摘要

背景

探讨妊娠糖尿病患者皮质醇、胰岛素样生长因子1(IGF1)和性激素结合球蛋白(SHBG)水平变化与胰岛素抵抗及糖脂代谢之间的相关性。

方法

本研究纳入110例诊断为妊娠期糖尿病的孕妇作为GDM组,另130例健康孕妇作为对照组。进行数据收集、相关指标检测及组间指标差异比较。采用Pearson相关分析确定与GDM发生相关的风险变量,采用二元logistic回归确定GDM发生的危险因素。

结果

与对照组相比,GDM组的空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、甘油三酯(TG)、游离脂肪酸(FFA)、脂蛋白磷脂酶A2(Lp-PLA2)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、皮质醇和IGF-1水平显著更高(P<0.05),但SHBG和HOMA-β水平显著更低。发现HOMA-IR与FPG、HbA1c、FINS、TG、FFA、Lp-PLA2、皮质醇和IGF-1呈正相关,而与SHBG呈负相关。发现FINS和SHBG是GDM的独立保护因素(OR=0.463,0.801,P<0.05),而HbA1c、TG、FFA和妊娠体重指数是GDM的独立危险因素(OR=1.992,4.234,1.990,1.629,P<0.05)。

结论

SHBG、IGF-1和皮质醇均与糖脂代谢指标相关,血清激素表达异常是胰岛素抵抗的主要原因。

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