CAJ | 학술논문

目的探讨血糖控制满意的妊娠期糖尿病(GDM)孕妇血清抵抗素水平、胰岛素抵抗与妊娠结局的关系.方法选取孕24～ 28周GDM孕妇98例,其中血糖控制满意的72例为血糖控制满意组,血糖控制不满意的26例为血糖控制不满意组.选取同期孕24～28周健康孕妇95例为健康对照组.分别于孕24～28周和孕37 ～ 40周测定三组孕妇空腹血清抵抗素、空腹血糖(FPG)和空腹胰岛素(FINS).计算稳态模型胰岛素抵抗指数(HOMA-IR).记录并观察三组孕妇的妊娠结局.结果血糖控制满意组孕妇的早产、妊娠期高血压疾病、羊水过多、巨大儿、新生儿窒息、新生儿低血糖、剖宫产的发生率明显低于血糖控制不满意组,两组比较差异有统计学意义(P＜0.05);血糖控制满意组孕妇妊娠期高血压疾病、巨大儿的发生率与健康对照组比较差异有统计学意义(P＜0.05),而早产、羊水过多、新生儿窒息、新生儿低血糖、剖宫产的发生率与健康对照组比较差异无统计学意义(P＞0.05).孕24 ～ 28周时,血糖控制满意组抵抗素、FINS、FPG、HOMA-IR明显低于血糖控制不满意组,但明显高于健康对照组,组间比较差异均有统计学意义(P＜0.05).孕37 ～ 40周时,血糖控制满意组FINS、HOMA-IR仍明显低于健康对照组,组间比较差异均有统计学意义(P＜0.05);但血糖控制满意组抵抗素、FPG与健康对照组差异无统计学意义(P＞0.05).结论随着血糖水平控制,GDM患者抵抗素水平下降,但高胰岛素抵抗仍持续存在.血糖控制满意并不能完全改善GDM患者的妊娠结局.
목적 탐토혈당공제만의적임신기당뇨병(GDM)잉부혈청저항소수평、이도소저항여임신결국적관계.방법 선취잉24～ 28주GDM잉부98례,기중혈당공제만의적72례위혈당공제만의조,혈당공제불만의적26례위혈당공제불만의조.선취동기잉24～28주건강잉부95례위건강대조조.분별우잉24～28주화잉37 ～ 40주측정삼조잉부공복혈청저항소、공복혈당(FPG)화공복이도소(FINS).계산은태모형이도소저항지수(HOMA-IR).기록병관찰삼조잉부적임신결국.결과 혈당공제만의조잉부적조산、임신기고혈압질병、양수과다、거대인、신생인질식、신생인저혈당、부궁산적발생솔명현저우혈당공제불만의조,량조비교차이유통계학의의(P＜0.05);혈당공제만의조잉부임신기고혈압질병、거대인적발생솔여건강대조조비교차이유통계학의의(P＜0.05),이조산、양수과다、신생인질식、신생인저혈당、부궁산적발생솔여건강대조조비교차이무통계학의의(P＞0.05).잉24 ～ 28주시,혈당공제만의조저항소、FINS、FPG、HOMA-IR명현저우혈당공제불만의조,단명현고우건강대조조,조간비교차이균유통계학의의(P＜0.05).잉37 ～ 40주시,혈당공제만의조FINS、HOMA-IR잉명현저우건강대조조,조간비교차이균유통계학의의(P＜0.05);단혈당공제만의조저항소、FPG여건강대조조차이무통계학의의(P＞0.05).결론 수착혈당수평공제,GDM환자저항소수평하강,단고이도소저항잉지속존재.혈당공제만의병불능완전개선GDM환자적임신결국.
Objective To investigate the relationships among the serum levels of resistin,insulin resistance and pregnancy outcomes in gestational diabetes mellitus (GDM) pregnant women with well-controlled glucose.Methods A total of 98 GDM pregnant women of 24-28 weeks were recruited.Seventy-two cases of GDM with well-controlled glucose were defined as glycemic satisfied group,26 cases with unsatisfied glucose were defined as glycemic unsatisfied group.Ninety-five healthy pregnant women of 24-28 weeks at the same period were defined as healthy control group.Serum resistin,fasting plasma glucose (FPG),fasting insulin (FINS) of all pregnant women were measured at 24-28 weeks and 37-40weeks.The Home model insulin resistance index(HOMA-IR) was calculated.The pregnancy outcomes of the three groups were recorded and observed.Results Glycemic satisfied group had less incidence of premature birth,hypertension disorders complicating pregnancy,polyhydramnios,fetal macrosomia,meonatal asphyxia,meonatal hypoglycemia,cesarean section compared to glycemic unsatisfied group,and the differences were statistically significant (P＜ 0.05).When compared to healthy control group,no significant differences were found in incidence of premature birth,polyhydramnios,meonatal asphyxia,meonatal hypoglycemia,cesarean section in glycemic satisfied group(P ＞ 0.05),but there were significant differences in incidence of hypertension disorders complicating pregnancy and fetal macrosomia in glycemic satisfied group (P ＜0.05).At 24-28 weeks,resistin,FINS,FPG,HOMA-IR in glycemic satisfied group were significantly lower than those in glycemic unsatisfied group (P ＜ 0.05),but which were higher than those in healthy control group (P ＜ 0.05).At 37-40 weeks,FINS,HOMA-IR in glycemic satisfied group were significantly lower than those in glycemic unsatisfied group (P ＜ 0.05),but there were no significant differences in resistin,FPG among three groups (P ＞ 0.05).Conclusions The serum levels of resistin of GDM pregnant women decrease when blood glucose is well controlled,but high insulin resistance still exists.Well-controlled glucose can not completely improve pregnancy outcomes of GDM pregnant women.