Hidvégi J, Paulin F, Megyeri J, Szabó G, Görbe E, Rigó J, Tóth-Pál E
Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 1995 Mar 12;136(11):599-601.
Insulin concentrations of 284 amniotic fluid samples were assessed, obtained from pregnant women by genetic amniocentesis between the 16-18 gestational weeks. The indication of amniocentesis was either advanced maternal age (> 35 years) or high risk genetic history. The amniotic fluid insulin concentration (mean +/- SD) was found 3.8 +/- 3.0 microIU/ml. The insulin concentration in 4.3% of all pregnant women was higher than the mean value +2 SD (9.8 microIU/ml) which represents individual pathological value, characteristic for gestational diabetes. Our data suggest that one part of gestational diabetes might be detected between the 16-18 gestational weeks, therefore we propose an earlier screening as the usual one. At institutes where the possibility of genetic amniocentesis is given the determination of insulin level in amniotic fluid may be reasonable. We could analyze the outcome of 230 pregnancies analysed. A close correlation was found between the amniotic fluid insulin concentration and birthweights of female newborns. It could not found such correlation at male newborn. A more careful screening test for gestational diabetes should be performed at mothers with female fetuses.
对284份羊水样本的胰岛素浓度进行了评估，这些样本是在妊娠16至18周期间通过基因羊膜穿刺术从孕妇获取的。羊膜穿刺术的指征为产妇年龄较大（>35岁）或有高危遗传史。羊水胰岛素浓度（均值±标准差）为3.8±3.0微国际单位/毫升。所有孕妇中4.3%的胰岛素浓度高于均值加2个标准差（9.8微国际单位/毫升），这代表个体病理值，是妊娠期糖尿病的特征。我们的数据表明，部分妊娠期糖尿病可能在妊娠16至18周期间被检测到，因此我们建议进行比常规筛查更早的筛查。在有条件进行基因羊膜穿刺术的机构，测定羊水胰岛素水平可能是合理的。我们能够分析230例妊娠的结果。发现羊水胰岛素浓度与女婴出生体重之间存在密切相关性。在男婴中未发现这种相关性。对于怀有女胎的母亲，应进行更仔细的妊娠期糖尿病筛查试验。
