摘要
目的:分析妊娠期糖尿病(GDM)孕妇胰岛素分泌特点及母婴结局。方法:回顾性选择本院住院分娩孕妇,根据OGTT及服糖后胰岛素水平分组,分析各组间胰岛素分泌特点、胰岛素抵抗及胰岛β细胞功能指标,比较不同胰岛素分泌特点及母婴结局。结果:GDM各组在不同时点G0、G60及G120血糖值均高于血糖正常组,且GDM1、GDM2、GDM3组间水平呈递增趋势(P<0.05);GDM各组I120胰岛素水平高于血糖正常组,且GDM1、GDM2、GDM3组间水平呈递增趋势(P<0.05);GDM各组I0、I180胰岛素水平高于血糖正常组,其中GDM3组最高(P<0.05);与血糖正常组比较,GDM各组HOMA-IR升高,ISIcomp、MBCI及ΔI30/ΔG30降低(P<0.05),在GDM1、GDM2、GDM3组HOMA-IR呈递增趋势,ISIcomp、MBCI及ΔI30/ΔG30呈递减趋势(P<0.05);服糖后120min达峰值组巨大儿发生率最高(P<0.05),羊水过多、胎膜早破、早产及新生儿低血糖的发生率在不同峰值组无差异(P>0.05)。结论:GDM孕妇胰岛素水平升高且峰值延迟至糖负荷后120min,且峰值胰岛素水平与胰岛素抵抗及胰岛■细胞下降趋势一致,均与病情程度有关,胰岛素峰值延迟可能增加巨大儿的发生风险。
Objective:To analyze the characteristics of insulin secretion in pregnant women with gestational diabetes mellitus(GDM),and to analyze the influence on the maternal and infant outcomes.Methods:The data of pregnant women were retrospective analyzed.According to OGTT results and insulin levels,the included women were divided into different groups.The characteristics of insulin secretion,insulin resistance,and islet beta cell function indexes of all women were analyzed,and the characteristics of insulin secretion,and maternal and infant outcomes were compared among the groups.Results:The blood glucose value and insulin levels,and HOMA-IR of women with GDM at G0,G60 and G120 time were significant higher than those of women with normal blood glucose(P<0.05),but the ISIcomp,MBCI andΔI30/ΔG30 were significant lower(P<0.05).The incidence of macrosomia of women with their blood glucose level increased to peak at 120 min after OGTT was highest(P<0.05).There were no statistically significant differences in the incidence of hyperhydramnios,premature rupture of membranes,preterm delivery,and neonatal hypoglycemia among the three groups(P>0.05).Conclusion:The pregnant women with GDM whose insulin level increase to the peak and delay until 120 min after glucose load,and the peak of insulin level is consistent with the trend of insulin resistance and decline of islet beta cells,which are all related to the degree of GDM.The delayed peak of insulin level may also increase the risk of macrosomia.
作者
俞丽华
YU Lihua(The Fourth People's Hospital of Yuyao City,Zhejiang province,315470)
出处
《中国计划生育学杂志》
2019年第6期752-755,共4页
Chinese Journal of Family Planning
关键词
妊娠期糖尿病
胰岛素分泌
胰岛素抵抗
妊娠结局
Gestational diabetes mellitus
Insulin secretion
Insulin resistance
Pregnancy outcomes
