胰岛素分泌异常与胰岛素抵抗在妊娠期糖尿病发病中的作用

目的：探讨胰岛素分泌异常与胰岛素抵抗在妊娠期糖尿病（GDM）发病中的作用。方法：通过检测40例GDM患者（GDM组）和40例正常孕妇（NGT组）的空腹胰岛素（FINS）和空腹血糖（FPG）,计算胰岛分泌功能指数（IFI）和HOMA稳态模型胰岛素抵抗指数（IRI）,比较两组孕妇胰岛素分泌能力和胰岛素抵抗程度的差异,并分析IFI与IRI之间的关系。结果：反映胰岛素分泌功能的IFI和FINS,GDM组明显高于NGT组（P〈0.01）;反映胰岛素抵抗程度的IRI,GDM组亦明显高于NGT组（P〈0.01）;GDM组和NGT组的IFI与IRI均呈显著正相关（r=0.564,P〈0.01和r=0.881,P〈0.01）。结论：与糖代谢正常的孕妇比较,GDM的孕妇存在胰岛素分泌相对不足和更为严重的胰岛素抵抗。

The Effects of Abnormal Insulin Secretion and Insulin Resistance on Invasion of Gestational Diabetes Mellitus

Objective： To study the effects of abnormal insulin secretion and insulin resistance on the invasion of gestational diabetes mellitus （GDM）. Methods： The levels of fasting insulin （FINS） and fasting plasma glucose （FPG） of 40 GDM patients （group GDM ） and 40 normal pregnant women （group NGT） were detected, and islet secretive function index （IFI） and insulin resistance index （IRI） in homeostasis model HOMA were calculated. The islet secretive function and insulin resistance degree of the 2 groups were compared and the relationship between IFI and IRI was analyzed. Results： （1） IFI, IRI and FINS levels were significantly higher in the group GDM than those in group NGT （P 〈0.01）; （2） there were significantly positive correlations between IFI and IRI in groups GDM and NGT （r =0. 564,P =0. 000; r =0. 881 ,P =0. 000 respectively）. Conclusion： There is relative shortage of insulin secretion and severer insulin resistance in pregnant women with GDM compared with those pregnant women with normal metabolism.