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目的探讨妊娠期糖尿病(GDM)孕妇铁储备的变化及其与胰岛素抵抗的关系。方法1152例孕妇按血糖筛查和糖耐量试验结果筛选出GDM孕妇42例(GDM组),随机选择糖耐量正常孕妇42例(normal glucose tolerence,NGT组),分别测定2组孕妇的空腹血糖(FPG)、空腹胰岛素(FIns)、血清铁蛋白(SF)、血清可溶性转铁蛋白受体(sTfR)以及sTfR与SF对数的比值(sTfR/lgSF),计算胰岛素抵抗指数(HOMA-IR)以评价胰岛素抵抗,并对两组孕妇的相应指标作对比和相关分析。结果GDM和妊娠期糖耐量受损(GIGT)的患病率分别为3.65%和11.81%;与对照组相比,GDM组的FPG、FIns、SF和HOMA-IR明显升高,而sTfR、sTfR/lgSF明显下降,其间差异有显著意义(P<0.05);GDM组孕妇血清sTfR/lgSF水平与FIns和HOMA-IR呈负相关(r值分别为-0.534、-0.620,均P<0.05)。结论铁储备与GDM患者胰岛素抵抗密切相关,可作为GDM防治新的着眼点之一。
Objective To investigate the changes of iron reserve in pregnant women with gestational diabetes mellitus (GDM) and its relationship with insulin resistance. Methods A total of 422 GDM pregnant women (GDM group) were screened by blood glucose screening and glucose tolerance test in 1152 pregnant women. Forty-two pregnant women with normal glucose tolerance (NGT) were randomly selected. The fasting blood glucose The insulin resistance index (HOMA-IR) was calculated as the ratio of sTfR to SF (sTfR / lgSF), FPG, FIns, SF, sTfR, Evaluation of insulin resistance, and the corresponding indicators of the two groups of pregnant women for comparison and correlation analysis. Results The prevalences of GIGT and gestational IGT were 3.65% and 11.81%, respectively. Compared with the control group, the FPG, FIns, SF and HOMA-IR of GDM group were significantly increased, while sTfR, sTfR (P <0.05). The levels of serum sTfR / lgSF in pregnant women with GDM were negatively correlated with FIns and HOMA-IR (r = -0.534 and -0.620, all P <0.05). Conclusion Iron reserve is closely related to insulin resistance in GDM patients and may be one of the new focuses of GDM prevention and treatment.