妊娠糖尿病合并胆石症与胰岛素抵抗的相关性研究

目的：探讨妊娠糖尿病合并胆石症与胰岛素抵抗之间的相互关系。方法采用病例对照法,分别测定40例单纯妊娠糖尿病（A组）及40例妊娠糖尿病合并胆石症（B组）患者的空腹血糖（FPG）、空腹胰岛素（FINS）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,并计算胰岛素抵抗指数（HOMA-IR）和胰岛素敏感指数（ISI）,观察各指标的变化及其相互关系。结果与A组比较,B组患者的FPG、FINS、TG、TC、LDL-C明显升高,ISI显著下降,HDL-C无显著性变化,存在更明显的胰岛素抵抗。 ISI与TG、TC、LDL-C呈负相关,与HDL-C呈正相关,多元回归分析显示胆石症与ISI呈负相关,与HOMA-IR呈正相关。结论胰岛素抵抗可能是导致妊娠糖尿病形成胆石症的危险因素,积极改善妊娠糖尿病胰岛素抵抗的相关因素,可能成为预防妊娠糖尿病合并胆石症的一种方案。

Correlation study of insulin resistance and cholelithiasis in patients with gestational diabetes mellitus

Objective To study the correlation between the insulin resistancce and cholelithiasis in patients with gestational diabetes mellitus. Methods A case-match study was carried out,the fasting blood glucose （FPG）,fasting insulin （FINS）,total cholesterol （TC）,higher triglyceride（TG）,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL-C） were measured in 40 gestational diabetes mellitus with cholelithiasis （group A） and 40 without cholelithiasis （group B）,retrospectively.Insulin resistance （HOMA-IR） and insulin sensitivity index（ISI） were calculated. The changes of the indicators were observed and their correlation were analyzed. Results Compared with group A,the FBG,FINS,TG,TC,LDL-C were significantly increased and ISI was decreased,HDL-C was no significantly changed and there was significantly insulin resistance in group B.ISI was negatively correlated with TG,TC and LDL-C,and positively with HDL-C.Multiple regression analysis showed that there was negative correlation between cholelithiasis and ISI, and positively with HOMA-IR. Conclusion Insulin resistance might be a risk factor for gestational diabetes mellitus with cholelith.Actively improve the related factors of gestational diabetes mellitus insulin resistance,can be prevent gestational diabetes mellitus with cholelith.