Robinson S, Viira J, Learner J, Chan S P, Anyaoku V, Beard R W, Johnston D G
Unit of Metabolic Medicine, St Mary's Hospital Medical School, Paddington, London, UK.
Diabet Med. 1993 Mar;10(2):139-45. doi: 10.1111/j.1464-5491.1993.tb00031.x.
Insulin sensitivity and postprandial thermogenesis were investigated at various stages of pregnancy to assess if changes in insulin sensitivity contribute to energy conservation during pregnancy. Cross-sectional and longitudinal studies were undertaken. Sixteen control non-pregnant women were compared with 10 women in the second trimester (2nd) and thirteen women in the third trimester (3rd) of uncomplicated pregnancy. Six women were studied at all three time points. The slope of plasma glucose decline following a bolus of intravenous insulin was used as an index of insulin sensitivity. Resting energy expenditure was measured with continuous indirect calorimetry. Postprandial thermogenesis was measured as the change in energy expenditure for the 2 h after a mixed meal. Results are expressed as mean +/- SEM or median (interquartile range). Insulin sensitivity was lower as pregnancy progressed (non-pregnant control 181 (177-205) vs 2nd 111 (100-112) vs 3rd 96 (80-109) mumol l-1 min-1, p < 0.001). Fasting insulin levels were significantly higher in the third trimester but not in the second trimester (non-pregnant control 1.9 (1.5-6.0) vs 2nd 3.1 (2.8-5.2) vs 3rd 8.6 (4.8-9.7) mU l-1, p < 0.05). Meal stimulated insulin levels were higher in the second and third trimesters compared to non-pregnant women (insulin area over 2 h, postmeal, non-pregnant control 78 +/- 10 vs 2nd 92 +/- 14 vs 3rd 145 +/- 14 mU l-1 h-1, p < 0.005). Postprandial thermogenesis was lowest in the third trimester (non-pregnant control 103 +/- 5 vs 2nd 74 +/- 8 vs 3rd 48 +/- 8 kJ, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
在孕期的各个阶段对胰岛素敏感性和餐后产热进行了研究，以评估胰岛素敏感性的变化是否有助于孕期的能量保存。开展了横断面研究和纵向研究。将16名未怀孕的对照女性与10名处于孕中期（第二孕期）和13名处于孕晚期（第三孕期）的单胎妊娠女性进行比较。6名女性在所有三个时间点接受了研究。静脉注射胰岛素推注后血浆葡萄糖下降的斜率用作胰岛素敏感性指标。通过连续间接测热法测量静息能量消耗。餐后产热通过混合餐后2小时能量消耗的变化来测量。结果以平均值±标准误或中位数（四分位间距）表示。随着孕期进展，胰岛素敏感性降低（未怀孕对照组181（177 - 205）对比第二孕期111（100 - 112）对比第三孕期96（80 - 109）μmol l-1 min-1，p < 0.001）。空腹胰岛素水平在第三孕期显著升高，但在第二孕期未升高（未怀孕对照组1.9（1.5 - 6.0）对比第二孕期3.1（2.8 - 5.2）对比第三孕期8.6（4.8 - 9.7）mU l-1，p < 0.05）。与未怀孕女性相比，第二和第三孕期进餐刺激后的胰岛素水平更高（餐后2小时胰岛素面积，未怀孕对照组78 ± 10对比第二孕期92 ± 14对比第三孕期145 ± 14 mU l-1 h-1，p < 0.005）。餐后产热在第三孕期最低（未怀孕对照组103 ± 5对比第二孕期74 ± 8对比第三孕期48 ± 8 kJ，p < 0.01）。（摘要截断于250字）
