妊娠期糖尿病游离脂肪酸与血糖、血脂代谢的关系研究

目的探讨GDM患者体内FFA浓度的变化，阐明其与血糖脂代谢的关系，进一步探讨GDM发病过程中IR的可能机制。方法测定76例GDM患者及56例正常孕妇组分娩前空腹血糖、血脂、FFA、FINs及HbAlc水平。计算HOMA—IR，并行GDM患者FFA与BMI、TG、TC、HOMA—IR相关性比较。结果与正常组孕妇相比。GDM组孕妇空腹血糖、TG、TC、FFA及LDL水平均明显升高（P均〈0．05）。而正常组孕妇HDL水平明显高于GDM组HDL水平。FFA与BMI、TG、TC、HOMA—IR均呈正相关。结论孕期高FFA能够影响胰岛素的合成和分泌，诱导和加重IR过程．导致GDM发生。

The study of the relation of FFA, glucose and lipid metabolism in patients with gestational diabetes mellitus

Objective To study the serum concentration changes in FFA and its possible relationship with the blood glucose and lipid metabolism, then understand the proper pathogenesis of insulin resistance in gestational diabetes mellitus. Methods Seventy-six cases with gestational diabetes mellitus （GDM） were selected as the experimental group, while 56 cases of control group at full-term received cesarean delivery were selected in our experiment. The levels of blood glucose, blood lipid, FFA, insulin and glycated hemoglobin in these people before labor were detected. HOMA- IR were also calculated in all the pregnant women in our experiment. All data were compared between the two groups in turns, the correlation between FFA and BMI, TG, TC, and HOMA-IR in pregnant women were compared. Results Compared with control group, the levels of FPG, TG, TC, FFA and LDL in GDM group increased significantly （P 〈 0.05）. but the level of HDL in GDM group decreased significantly （P 〈 0.05）. There were significant correlations between the FFA and BMI, TG, TC, HOMA-IR in serum of mothers. Conclusion The high levels of FFA can influence the synthesis and secretion of insulin, induce and aggravate IR during pregnancy, even lead to GDM.