中国糖尿病杂志
中國糖尿病雜誌
중국당뇨병잡지
CHINESE JOURNAL OF DIABETES
2008年
3期
131-133
,共3页
平凡%向红丁%张俊吉%李伟%陈伟%回园敕%张葵%聂敏%黎明%刘俊涛%覃舒文
平凡%嚮紅丁%張俊吉%李偉%陳偉%迴園敕%張葵%聶敏%黎明%劉俊濤%覃舒文
평범%향홍정%장준길%리위%진위%회완칙%장규%섭민%려명%류준도%담서문
妊娠糖尿病%胰岛素敏感性%功能,β细胞
妊娠糖尿病%胰島素敏感性%功能,β細胞
임신당뇨병%이도소민감성%공능,β세포
Function, β cell
目的 比较妊娠糖尿病(GDM)及糖耐量减低(IGT)与糖耐量正常(NGT)孕妇的胰岛素敏感性(IS)及胰岛β细胞功能的差异,并寻找合理的评价指标,观察早期干预对妊娠结局的影响.方法 比较313例NGT、128例IGT及270例GDM孕妇的临床特征,前瞻性研究糖负荷后的IS和β细胞功能,并对IGT及GDM组进行前瞻性干预.结果 (1)IGT及GDM组的孕前BMI、WBC、ALT等指标较NGT组升高.(2)IGT、GDM组较NGT组的HOMA-IR、HOMA2-IR升高,△Ins,60/△Glu50、IS-QUICKI及IS-OGTT则降低.(3)IGT及GDM组中除23例(5.8%)加用人胰岛素治疗外其余仅单纯饮食控制即可达标.分娩时其孕重增加较NGT组为少,且新生儿体重及巨大儿发生率与NGT组相当.结论 胰岛素抵抗及β细胞功能代偿不足在GDM的发生中均起重要作用.评价孕期β细胞功能时,引入糖负荷后的指标可能更为准确.IGT及GDM孕妇经干预后巨大儿发生率可降低至正常孕妇水平.
目的 比較妊娠糖尿病(GDM)及糖耐量減低(IGT)與糖耐量正常(NGT)孕婦的胰島素敏感性(IS)及胰島β細胞功能的差異,併尋找閤理的評價指標,觀察早期榦預對妊娠結跼的影響.方法 比較313例NGT、128例IGT及270例GDM孕婦的臨床特徵,前瞻性研究糖負荷後的IS和β細胞功能,併對IGT及GDM組進行前瞻性榦預.結果 (1)IGT及GDM組的孕前BMI、WBC、ALT等指標較NGT組升高.(2)IGT、GDM組較NGT組的HOMA-IR、HOMA2-IR升高,△Ins,60/△Glu50、IS-QUICKI及IS-OGTT則降低.(3)IGT及GDM組中除23例(5.8%)加用人胰島素治療外其餘僅單純飲食控製即可達標.分娩時其孕重增加較NGT組為少,且新生兒體重及巨大兒髮生率與NGT組相噹.結論 胰島素牴抗及β細胞功能代償不足在GDM的髮生中均起重要作用.評價孕期β細胞功能時,引入糖負荷後的指標可能更為準確.IGT及GDM孕婦經榦預後巨大兒髮生率可降低至正常孕婦水平.
목적 비교임신당뇨병(GDM)급당내량감저(IGT)여당내량정상(NGT)잉부적이도소민감성(IS)급이도β세포공능적차이,병심조합리적평개지표,관찰조기간예대임신결국적영향.방법 비교313례NGT、128례IGT급270례GDM잉부적림상특정,전첨성연구당부하후적IS화β세포공능,병대IGT급GDM조진행전첨성간예.결과 (1)IGT급GDM조적잉전BMI、WBC、ALT등지표교NGT조승고.(2)IGT、GDM조교NGT조적HOMA-IR、HOMA2-IR승고,△Ins,60/△Glu50、IS-QUICKI급IS-OGTT칙강저.(3)IGT급GDM조중제23례(5.8%)가용인이도소치료외기여부단순음식공제즉가체표.분면시기잉중증가교NGT조위소,차신생인체중급거대인발생솔여NGT조상당.결론 이도소저항급β세포공능대상불족재GDM적발생중균기중요작용.평개잉기β세포공능시,인입당부하후적지표가능경위준학.IGT급GDM잉부경간예후거대인발생솔가강저지정상잉부수평.
Objective To determine metabolic disorders in GIGT and GDM, and investigate the valid insulin sensitivity indices.We also evaluated the impact of early intervention on pregnant outcome. Methods The insulin sensitivity and the function of β cell were studied among 313 GNGT, 280 GDM and 128 GIGT, and intervention on GIGT and GDM was provided. Results 1)Age,pregravidic levels of BMI, WBC counts and ALT were significantly higher in GIGT and GDM than in GNGT.2) In GIGT and GDM vs.NGT,HOMA-IR and HOMA2-IR were significantly higher while IS-QUICKI, IS-OGTT and △I60 /△G60 were lower.3) GIGT and GDM underwent diet control except 23 cases (5.78%) received insulin injection.Compared to GNGT, the gestational weight gain was significantly lower in GIGT and GDM.No statistical difference was found in the prevalence of fetal macrosomia and in the neonate body weight. Conclusions The impaired function of the pancreatic β cell and the increase of insulin resistance play a vital role in the pathogenesis of GDM.Markers associated with the changes of plasma glucose and insulin levels after glucose loading might be used to evaluate more precisely the function of β cell during pregnancy.The increased WBC counts and ALT level can also be the insulin resistance indices of early pregnancy.Most of the pregnant women with abnormal glucose tolerance undergoing diet intervention show very good control.
