妊娠糖尿病患者血清鸢尾素与胰岛β细胞功能的相关性

目的 探讨妊娠糖尿病(GDM)患者空腹血清鸢尾素(Irisin)与胰岛细胞功能之间的关系。方法 选取2014年10月至2015年4月安徽医科大学第一附属医院妊娠24~32周孕妇100例,根据口服葡萄糖耐量试验(OGTT)结果分为GDM组和正常对照组(NGT),采用酶联免疫吸附法(ELISA)检测各组空腹血清Irisin水平,同时测定各受试者身高、体质量、血脂及OGTT各点血糖指标,并计算胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β),分析这些指标与血清Irisin之间的关系。结果 与NGT组相比,GDM组空腹血清Irisin水平明显降低,差异有统计学意义(P<0.05)。空腹血清Irisin与HOMA-β及高密度脂蛋白呈正相关,与孕前体重指数(BMI)及空腹血糖、1小时血糖、2小时血糖、空腹C肽、HOMA-IR、三酰甘油、极低密度脂蛋白呈负相关。空腹血糖为空腹血清Irisin的独立影响因素。结论 GDM妇女血清Irisin水平下降,与胰岛β细胞功能正相关,和胰岛素抵抗有关,可能参与了GDM的发生发展过程。

Correlation between serum irisin and pancreatic beta-cell function in patients with gestational diabetes mellitus

Objective To investigate the correlation between fasting serum irisin and pancreatic beta-cell function in the patients with gestational diabetes mellitus(GDM). Methods A 75 g oral glucose tolerance test(OGTT) was performed among 100 pregnant women in the 24 to 32 gestational weeks, and then these pregnant women were divided into the GDM group and the normal glucose tolerance(NGT) group according to the OGTT results. The fasting serum irisin levels were measured by enzyme-linked immune-sorbent assay(ELISA). Meanwhile, the indexes of height, weight, blood lipid, and OGTT of all participants were measured, and their HOMA-insulin resistance index(HOMA-IR) and HOMA-beta-cell insulin secretion index(HOMA-beta) were also calculated for the relation analysis of irisin with these parameters. Results The serum irisin levels of GDM group were significantly lower than those of the NGT group, and the difference was statistically significant(P<0.05). Furthermore, the fasting serum irisin was found to correlate positively with HDL-C and HOMA-beta, but to correlate negatively with BMI before pregnancy, OGTT results, C peptide, HOMA-IR, TG and VLDL-C. The fasting plasma glucose was an independent influencing factor of the fasting serum irisin. Conclusion Decrease in the serum irisin level of GDM women correlates positively with the pancreatic beta-cell function and negatively with the insulin resistance, which might play an important role in the development and progression of GDM.