中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
1期
21-23
,共3页
赖丽萍%邵豪%陆泽元%李翠吟%庄荀芳%尤晓玲%张国良
賴麗萍%邵豪%陸澤元%李翠吟%莊荀芳%尤曉玲%張國良
뢰려평%소호%륙택원%리취음%장순방%우효령%장국량
胰岛素抵抗%超敏C-反应蛋白%糖尿病%妊娠
胰島素牴抗%超敏C-反應蛋白%糖尿病%妊娠
이도소저항%초민C-반응단백%당뇨병%임신
Insulin resistance%High sensitive C-reactive protein%Diabetes%Gestational
目的 研究孕妇在不同糖耐量状态下血清超敏C-反应蛋白(hs-CRP)与胰岛素抵抗(IR)的关系.方法 孕妇孕24～28周行50 g口服葡萄糖负荷试验,阳性者再行75 g口服葡萄糖耐量试验,根据血糖结果分为妊娠糖尿病组41例、糖耐量减低组30例和糖耐量正常组27例,用ELISA方法测定hs-CRP水平,同时计算稳态模式胰岛素抵抗指数(HOMA-IR)、稳态模式胰岛B细胞功能指数(HBCI)和30 min净增胰岛素/30 min净增血糖(△I30/△G30).结果 ①从糖耐量正常组到糖耐量减低组到妊娠糖尿病组,hs-CRP [(6.15±2.63)、(7.65±4.27)、(10.80 ±3.57)mg/L,F=5.628,P=0.021]、HOMA-IR(2.54±0.74、3.51±0.29、3.96 ±2.16,F=6.928,P=0.011)呈递增趋势,而HBCI(426.08±89.85、266.69±203.32、223.82 ±148.58,F=4.283,P:0.043)和△I30/△G30(27.90±19.22、15.12±12.50、13.13 ±12.98,F=6.505,P=0.014)呈递减倾向;②Pearson相关分析显示孕前BMI、空腹胰岛素(Fins)、hs-CRP与HOMA-IR正相关(r=0.320、0.833、0.288,P均＜0.01);多元回归分析显示,孕前BMI、FBG、Fins、hs-CRP是影响HOMA-IR的显著因素(回归系数分别为0.320、0.340、0.709、0.288,R2=0.92,P均＜0.01).结论 妊娠糖尿病患者的血清hs-CRP水平为影响IR的显著因素,提示hs-CRP可能通过多种机制加重IR,参与妊娠糖尿病的发病.
目的 研究孕婦在不同糖耐量狀態下血清超敏C-反應蛋白(hs-CRP)與胰島素牴抗(IR)的關繫.方法 孕婦孕24～28週行50 g口服葡萄糖負荷試驗,暘性者再行75 g口服葡萄糖耐量試驗,根據血糖結果分為妊娠糖尿病組41例、糖耐量減低組30例和糖耐量正常組27例,用ELISA方法測定hs-CRP水平,同時計算穩態模式胰島素牴抗指數(HOMA-IR)、穩態模式胰島B細胞功能指數(HBCI)和30 min淨增胰島素/30 min淨增血糖(△I30/△G30).結果 ①從糖耐量正常組到糖耐量減低組到妊娠糖尿病組,hs-CRP [(6.15±2.63)、(7.65±4.27)、(10.80 ±3.57)mg/L,F=5.628,P=0.021]、HOMA-IR(2.54±0.74、3.51±0.29、3.96 ±2.16,F=6.928,P=0.011)呈遞增趨勢,而HBCI(426.08±89.85、266.69±203.32、223.82 ±148.58,F=4.283,P:0.043)和△I30/△G30(27.90±19.22、15.12±12.50、13.13 ±12.98,F=6.505,P=0.014)呈遞減傾嚮;②Pearson相關分析顯示孕前BMI、空腹胰島素(Fins)、hs-CRP與HOMA-IR正相關(r=0.320、0.833、0.288,P均＜0.01);多元迴歸分析顯示,孕前BMI、FBG、Fins、hs-CRP是影響HOMA-IR的顯著因素(迴歸繫數分彆為0.320、0.340、0.709、0.288,R2=0.92,P均＜0.01).結論 妊娠糖尿病患者的血清hs-CRP水平為影響IR的顯著因素,提示hs-CRP可能通過多種機製加重IR,參與妊娠糖尿病的髮病.
목적 연구잉부재불동당내량상태하혈청초민C-반응단백(hs-CRP)여이도소저항(IR)적관계.방법 잉부잉24～28주행50 g구복포도당부하시험,양성자재행75 g구복포도당내량시험,근거혈당결과분위임신당뇨병조41례、당내량감저조30례화당내량정상조27례,용ELISA방법측정hs-CRP수평,동시계산은태모식이도소저항지수(HOMA-IR)、은태모식이도B세포공능지수(HBCI)화30 min정증이도소/30 min정증혈당(△I30/△G30).결과 ①종당내량정상조도당내량감저조도임신당뇨병조,hs-CRP [(6.15±2.63)、(7.65±4.27)、(10.80 ±3.57)mg/L,F=5.628,P=0.021]、HOMA-IR(2.54±0.74、3.51±0.29、3.96 ±2.16,F=6.928,P=0.011)정체증추세,이HBCI(426.08±89.85、266.69±203.32、223.82 ±148.58,F=4.283,P:0.043)화△I30/△G30(27.90±19.22、15.12±12.50、13.13 ±12.98,F=6.505,P=0.014)정체감경향;②Pearson상관분석현시잉전BMI、공복이도소(Fins)、hs-CRP여HOMA-IR정상관(r=0.320、0.833、0.288,P균＜0.01);다원회귀분석현시,잉전BMI、FBG、Fins、hs-CRP시영향HOMA-IR적현저인소(회귀계수분별위0.320、0.340、0.709、0.288,R2=0.92,P균＜0.01).결론 임신당뇨병환자적혈청hs-CRP수평위영향IR적현저인소,제시hs-CRP가능통과다충궤제가중IR,삼여임신당뇨병적발병.
Objective To investigate the association of serum high-sensitivity C-reactive protein(hs-CRP)with insulin resistance(IR)in pregnant women with different glucose tolerance.Methods Pregnant women at gestational age of 24-28 weeks were screened with 50 g glucose challenge test(GCT),and further 75 g oral glucose tolerance test(OGTT)were given to those positive subjects.Based on the results of OGTT,they were divided into three groups:41 gestational DM,30 gestational IGT and 27 subjects with normal glucose tolerance.ELISA was used to evaluate serum hs-CRP levels.homeostasis model insulin resistance index(HOMA-IR)was applied to assess the status of insulin resistance,homeostasis β-cell function index(HBCI)and 30 min net increment of insulin/30min net increment of glucose(△I30/△G30)were used to evaluate the basic function of islet βcells.Results ①hs-CRP [(6.15 ±2.63)mg/L vs(7.65 ±4.27)mg/L vs(10.80±3.57)mg/L,F=5.628,P=0.021]and HOMA-IR (2.54±0.74 vs 3.51 ±0.29 vs 3.96±2.16,F=6.928,P=0.011)increased,HBCI(426.08 ±89.85 vs 266.69±203.32 vs 223.82 ±148.58,F=4.283,P=0.043)and △I30/△G30(27.90±19.22 vs 15.12 ±12.50 vs 13.13±12.98,F=6.505,P=0.014)decreased progressively from normal glucose tolerance to gestational IGT to gestational DM;②Body mass index(BMI)before pregnancy,fasting insulin(Fins)and hs-CRP is statistically correlated to HOMA-IR(r=0.320、0.833、0.288,P＜0.01);Multiple regression analysis identified BMI before pregnancy,Fins and hs-CRP as the factors affecting HOMA-IR(regression coefficient of 0.320、0.709 and 0.288,respectively,R2=0.92.P＜0.01).Conclusions.Serum Levels of hs-CRP is elevated in women with gestational DM,wich is the most significant factor affecting IR,hs-CRP may aggravate insulin resistance through various mechanisms and participate in the pathogenesis of gestational diabetes mellitus.
