妊娠期糖尿病患者的血糖、血脂、血尿酸及胰岛素敏感性变化

目的：探讨妊娠期糖尿病（GDM）患者与胰岛素抵抗综合征（IRS）的关系。方法：测定130例GDM患者（GDM组）及125例正常孕妇（对照组）的空腹血浆葡萄糖（GLU）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、血尿酸（UA）、胰岛素（FINS）水平,计算胰岛素敏感指数（ISI）,两组比较。结果：校正孕妇年龄、孕龄、孕前体重和孕前体重指数（BMI）等因素后,GDM组100 g葡萄糖耐量试验各个时点血糖值均比对照组高,差异有显著性（P〈0.01）;GDM组的TC、TG、LDL-C、UA、FINS、ISI值均比对照组高,差异有显著性（P〈0.01）,而HDL-C值则比对照组低,差异也有显著性。结论：GDM孕妇的血糖、血脂、血尿酸及胰岛素水平均比正常孕妇高,而胰岛素敏感性则比正常孕妇低,存在更严重的胰岛素抵抗（IR）。GDM是IRS在妊娠期的一种特殊表现。

Level Changes of Glucose,Lipids,Uric Acid and Insulin Sensitivity in Patients with Gestational Diabetes Mellitus

Objective：To investigate the relationship between gestational diabetes mellitus （GDM） and insulin resistance symptom （IRS）. Methods：Fasting plasma glucose （GLU）,total cholesterol （TC）,triglyceride （TG）,low-density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, uric acid （UA）, fasting insulin （FINS） and insulin sensitivity index （ISI） were measured in 130 patients with GDM and 125 patients without GDM as normal control. Results：With correction for age,gestational duration,body weight and BMI before pregnancy,all point blood glucose of 100 g oral glucose tolerance test were higher in GDM patients than those in normal control（P〈0.01）. The levels of TC,TG,LDL-C,UA,FINS and ISI were higher in GDM （P〈0.01） ,while HDL-C was lower ,than those in normal control. Conclusions ：The levels of blood glucose,lipid,uric acid and insulin are higher in GDM compared with normal control,while insulin sensitivity is lower. GDM is a special manifestation of IRS in gestational period.