年龄对二次妊娠期糖尿病的胰岛素抵抗及胰岛β细胞功能影响的研究

目的研究初次妊娠未发生妊娠期糖尿病(gestational diabetes mellitus,GDM)的育龄期妇女在二次妊娠发生GDM时年龄对胰岛素抵抗(insulin resistance,IR)及胰岛β细胞功能的影响。方法选取2013年8月至2014年8四川省人民医院产科门诊139例初次妊娠时糖尿病耐量正常二次妊娠诊断为GDM的患者,按年龄分为高龄组(≥35岁,65例)和低龄组(35岁,74例)。比较两组患者GDM筛查时和产后6周的空腹血糖(fasting blood glucose,FBG)、空腹胰岛素水平,HOMA-IR,胰岛β细胞分泌指数(HOMA-IS)及产后6周血糖恢复情况。结果高龄组分娩前后FBG、空腹胰岛素(fasting insulin,FINS)、HOMA-IR水平以及产后遗留血糖异常率高于低龄组,而HOMA-IS较低(P0.05)。结论 GDM患者围产期高龄组较低龄组胰岛素抵抗更重,胰岛细胞功能更差,产后遗留血糖异常比例更高。

The influence of age on insulin resistance and beta-cell function in patients of secondary pregnancy with gestational diabetes mellitus

Objective To investigate the influence of age on insulin resistance( IR) and beta-cell function in patients in the second pregnancy with gestational diabetes mellitus( GDM) and without GDM in the first pregnancy. Methods Clinical data of 142 patients with GDM in the secondary pregnancy and without GDM in the first pregnancy treated in obstetrics clinic of Sichuan Provincial People's Hospital from August 2013 to August 2014 were selected. Divided them into two groups according to the different ages. They were elderly group (whose age ≥35, n=65) and young group (whose age < 35,n=74), respectively. The fasting blood glucose ( FBG)、fasting insulin level ( FINS)、HOMA-IR and HOMA-IS at the time of screening and 6 weeks postpartum in the two groups were examined and compared. Results Compared with the young group, the elderly group had higher level of FBG、FINS、HOMA-IR level and pathoglycemia rate postpartum, but lower HOMA-IS (P<0. 05). Conclusion Patients with GDM in elderly group had severer insulin resistance and worse islet cell function, higher pathoglycemia rate postpartum than young group.