妊娠期糖尿病孕妇血浆Ghrelin水平与胰岛素抵抗的研究

目的:观察妊娠期糖期尿病孕妇血浆ghrelin水平及其与体重指数(BMI)、血脂、血糖、胰岛素抵抗的相关性。方法:选取正常分娩的妊娠期糖尿病孕妇40例为研究组,对照组为正常孕妇40例,两组孕妇年龄、孕龄及BMI均无统计差异(P0.05)。对两组孕妇于孕28周进行75 g葡萄糖耐量试验(OGTT),测定0、1、2、3 h静脉血浆葡萄糖,如有2个或2个以上时点的血糖大于或等于临界值,则诊断为妊娠期糖尿病。酶联免疫吸附法(EIA)测定空腹血浆ghrelin浓度,并测定空腹血糖、胰岛素、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇,计算胰岛素敏感指数。结果:①与正常对照组比较,研究组孕妇FBG、FINS、TC、TG、LDL-C及HOMA-IR均明显升高(P0.01),HDL-C明显下降(P0.01)。②妊娠期糖尿病组血浆ghrelin水平显著低于对照组(P0.01)。Pearson相关分析表明,研究组孕妇血浆ghrelin与BMI、空腹血糖、空腹胰岛素及HOMA-IR呈负相关。结论:妊娠期糖尿病孕妇血浆存在糖脂代谢紊乱,胰岛素抵抗增加;妊娠期糖尿病孕妇ghrelin水平表达较正常孕妇显著降低;血浆ghrelin水平与胰岛素抵抗呈负相关;Ghrelin参与了孕期机体的能量代谢以及胰岛素抵抗的发生。

Investigation on plasma Ghrelin level and insulin resistance in pregnant women with gestational diabetes mellitus

Objective:To observe the correlation between serum Ghrelin level and body mass index(BMI),serum lipids,blood glucose and insulin resistance in pregnant women with gestational diabetes mellitus.Methods:40 pregnant women with gestational diabetes mellitus and 40 normal pregnant women were selected,there was no significant difference in maternal age,gestational age and BMI between the two groups(P>0.05);all the pregnant women in the two groups received 75g oral glucose tolerance test(OGTT) at 28 gestational weeks,the plasma glucose levels at 0,1,2,3 hours were detected,gestational diabetes mellitus was diagnosed according to the plasma glucose levels(plasma glucose levels at two time points or above two time points≥critical value);enzyme-linked immunosorbent assay was used to detect the fasting plasma Ghrelin level,the levels of fasting blood glucose,insulin,triglyceride,total cholesterol,low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) were also detected,insulin resistance index was calculated.Results:Compared with control group,the levels of fasting blood glucose,insulin,triglyceride,total cholesterol,LDL-C and insulin resistance index in study group increased significantly(P<0.01),the level of HDL-C decreased significantly(P<0.01);the plasma Ghrelin level in study group was significantly lower than that in control group(P<0.01);Pearson correlation analysis indicated that there was a negative correlation between plasma Ghrelin level and BMI,fasting blood glucose,insulin,insulin resistance index in study group.Conclusion:Glucose and lipid metabolism disturbance exist in pregnant women with gestational diabetes mellitus,and the incidence of insulin resistance increases;the plasma Ghrelin level in pregnant women with gestational diabetes mellitus is significantly lower than that in normal pregnant women;there is a negative correlation between plasma Ghrelin level and insulin resistance;Ghrelin participates in energy metabolism during pregnancy and the occurrence of insulin resistance.