摘要
目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇血、尿肌醇水平变化及其与糖脂代谢的相关性。方法本研究为横断面研究。以2018年11月至2019年8月于福建省妇幼保健院门诊常规产前检查的GDM孕妇80例作为GDM组,同期本院门诊常规产检的非GDM孕妇50例作为非GDM组。比较GDM组与非GDM组血、尿肌醇水平,糖脂代谢指标及其相关性。采用独立或成对样本t检验、Mann-Whitney秩和检验、χ^(2)检验或Fisher精确概率法,以及Pearson相关性分析等方法进行统计学分析。结果(1)GDM组血肌醇和高密度脂蛋白-胆固醇均低于非GDM组[分别为322.1 ng/ml(279.1~364.1 ng/ml)与403.8 ng/ml(391.8~425.3 ng/ml),Z=-7.879;1.8 mmol/L(1.5~2.0 mmol/L)与2.0 mmol/L(1.7~2.2 mmol/L),Z=-2.419;P值均<0.05]。GDM组尿肌醇、脂蛋白a、75 g口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)服糖前及服糖后1和2 h血糖、空腹胰岛素和糖化血红蛋白均高于非GDM组[分别为192.2 ng/ml(171.0~219.9 ng/ml)与143.8 ng/ml(121.1~158.6 ng/ml),Z=-6.834;253.2 mg/L(65.0~349.0 mg/L)与148.5 mg/L(46.5~159.3 mg/L),Z=-0.187;5.0 mmol/L(5.1~5.6 mmol/L)与4.4 mmol/L(4.2~4.6 mmol/L),Z=-5.547;10.0 mmol/L(9.1~11.3 mmol/L)与7.8 mmol/L(7.0~8.4 mmol/L),Z=-6.987;8.6 mmol/L(7.6~9.4 mmol/L)与6.6 mmol/L(5.7~7.1 mmol/L),Z=-7.100;18.2 mU/L(10.6~25.9 mU/L)与11.0 mU/L(6.3~12.7 mU/L),Z=-4.537;5.4%(4.5%~5.5%)与5.1%(4.9%~5.4%),Z=-3.468;P值均<0.05]。(2)血肌醇与空腹胰岛素、75 g OGTT服糖前及服糖后1和2 h血糖水平均呈负相关(r值分别为-0.386、-0.416、-0.350和-0.407);尿肌醇与75 g OGTT服糖前及服糖后1和2 h血糖水平呈正相关(r值分别为0.402、0.389和0.429),P值均<0.05。结论GDM孕妇血肌醇水平下降,而尿肌醇排泄增加。孕中期测定肌醇水平变化,可能有助于评估孕妇代谢情况。
Objective To investigate the correlation between inositol level and glycolipid metabolism in gravidas with gestational diabetes mellitus(GDM).Methods A cross-sectional study was conducted on 80 GDM cases undergoing routine examination at Fujian Provincial Maternity and Children's Hospital from November 2018 to August 2019,who were selected as GDM groups.Another 50 women with uncomplicated pregnancies during the same period were selected as the control group.Blood and urine inositol level and serum glycolipid profiles were compared between the two groups,and their association was analyzed.Independent or paired-sample t test,Mann-Whitney test,Chi-square(or Fisher's exact)test,and Pearson correlation test were performed for statistical analysis.Results The serum inositol concentration and high-density lipoprotein(HDL)cholesterol in the GDM group were significantly lower[322.1 ng/ml(279.1-364.1 ng/ml)vs 403.8 ng/ml(391.8-425.3 ng/ml),Z=-7.879;1.8 mmol/L(1.5-2.0 mmol/L)vs 2.0 mmol/L(1.7-2.2 mmol/L),Z=-2.419;both P<0.05],while the concentration of urine inositol,lipoprotein-a(lipo-a),0 h-,1 h-,2 h-oral glucose tolerance test(OGTT)glucose,fasting insulin,and glycosylated hemoglobin(HbA1c)were significantly higher when comparing to the control group[192.2 ng/ml(171.0-219.9 ng/ml)vs 143.8 ng/ml(121.1-158.6 ng/ml),Z=-6.834;253.2 mg/L(65.0-349.0 mg/L)vs 148.5 mg/L(46.5-159.3 mg/L),Z=-0.187;5.0 mmol/L(5.1-5.6 mmol/L)vs 4.4 mmol/L(4.2-4.6 mmol/L),Z=-5.547;10.0 mmol/L(9.1-11.3 mmol/L)vs 7.8 mmol/L(7.0-8.4 mmol/L),Z=-6.987;8.6 mmol/L(7.6-9.4 mmol/L)and 6.6 mmol/L(5.7-7.1 mmol/L),Z=-7.100;18.2 mU/L(10.6-25.9 mU/L)vs 11.0 mU/L(6.3-12.7 mU/L),Z=-4.537;5.4%(4.5%-5.5%)vs 5.1%(4.9%-5.4%),Z=-3.468;all P<0.05].(2)Serum inositol concentration was negatively correlated with fasting insulin and 0 h-,1 h-,2 h-OGTT glucose level(r=-0.386,-0.416,-0.350 and-0.407,respectively);urinary inositol concentration was positively correlated with 0 h-,1 h-,2 h-OGTT glucose levels(r=0.402,0.389 and 0.429,respectively)(all P<0.05).Conclusions Serum inos
作者
刘照贞
汤思佳
张宇龙
吴奕君
林晟
王晓梅
陈寿珍
Liu Zhaozhen;Tang Sijia;Zhang Yulong;Wu Yijun;Lin Sheng;Wang Xiaomei;Chen Shouzhen(Department of Obstetrics,Fujian Provincial Maternity and Children's Hospital,Affiliated Hospital of Fujian Medical University,Fuzhou 350001,China)
出处
《中华围产医学杂志》
CAS
CSCD
北大核心
2021年第5期366-371,共6页
Chinese Journal of Perinatal Medicine
关键词
糖尿病
妊娠
肌醇
胰岛素抵抗
Diabetes,gestational
Inositol
Insulin resistance
