胰岛素、C肽和葡萄糖与胎儿生长发育关系的研究

目的：探讨母血、脐血和羊水的胰岛素（INS）、C肽及葡萄糖（GLU）水平与胎儿生长发育的关系。方法选择妊娠期糖尿病（GDM）患者59例，同期单胎正常妊娠孕妇78例，测定母血、脐血、羊水的INS、C肽及GLU水平，并进行比较。结果（1）两组母血、脐血INS、C肽及GLU水平差异均有统计学意义（P＜0.05或0.01）。（2）两组母血、脐血的INS、C肽与新生儿体重、身长均无明显相关（均P＞0.05）；母血与脐血中C肽与INS水平明显相关（均P＜0.05）；对照组羊水INS和新生儿体重、身长均明显相关（均P＜0.05）。（3）多元回归分析显示孕妇年龄、孕前体重与新生儿出生体重密切相关（均P＜0.05）。结论可以通过测定血C肽的浓度间接反映母亲和胎儿体内的INS水平；羊水C肽水平可以作为评估胎儿宫内发育的指标；孕妇的孕前及孕期营养状况是影响胎儿宫内生长发育的主要因素之一。

Insulin,c-peptide and glucose levels in maternal blood,cord blood and amniotic fluid in relation to fetal development

Objective To investigate insulin, c- peptide and glucose levels in maternal blood, cord blood and amniotic fluid in relation to fetal development. Methods Fifty nine pregnant women with gestational diabetes mel itus（GDM） and 78 normal pregnant women （control group） were recruited from May 2011 to March 2012. Maternal blood, cord blood and amniotic fluid samples were col ected at delivery and measured for insulin INS）, C- peptide（C- P） and glucose（GLU）. Results There were sta-tistical differences in average levels of INS, C- P and GLU in maternal serum and cord blood between two groups（P〈0.05）. In the two groups, the levels of INS and C- P in maternal serum, cord blood serum were not correlated with neonatal weight and heights （P〉0.05）;in the control group, the concentration of INS in amniotic fluid was related to neonatal weight and heights （P〈0.05）. Multivariate regression analysis showed that maternal age, pre- pregnancy weight were closely related to newborn weight （P〈0.05）. Conclusion Maternal serum C- peptide levels may reflex maternal and fetal INS levels and C- peptide levels in amniotic fluid may be used as indicator to assess fetal intrauterine growth.