中国医药
中國醫藥
중국의약
CHINA MEDICINE
2015年
5期
689-693
,共5页
穆得润%侯灵彤%韩萍%李琳梅%董建新%穆冠吉
穆得潤%侯靈彤%韓萍%李琳梅%董建新%穆冠吉
목득윤%후령동%한평%리림매%동건신%목관길
妊娠期糖尿病%C肽%妊娠%胰岛素抵抗
妊娠期糖尿病%C肽%妊娠%胰島素牴抗
임신기당뇨병%C태%임신%이도소저항
Gestational diabetes mellitus%C peptide%Pregnancy%Insulin resistance
目的 探讨用改良后公式来评估妊娠期胰岛素敏感性的可行性.方法 对纳入的319名孕妇于妊娠24 ～ 32周行75 g口服葡萄糖耐量试验(OGTT),根据诊断结果分为妊娠期糖尿病(GDM)组(47名)与OGTT正常组(272名),比较空腹和服糖后60、120 min时2组孕妇的血糖、胰岛素和C肽水平.选择妊娠期胰岛素敏感性传统评价公式ISOGTT为参考指标并作为自变量,以用C肽替代胰岛素的3个改良后公式ISOGTTc-pep、ISHOMAc-pep和ISQUICKIc-pep为因变量,对这些因变量与白变量之间的相关性进行分析.结果 GDM组空腹、服糖后60 min与服糖后120 min时血糖水平[(4.9±1.0) mmol/L、(10.0±1.9) mmol/L、(8.5±1.9) mmol/L]均明显高于OGTT正常组[(4.2±0.4) mmol/L、(6.9±1.4) mmol/L、(6.1±1.0) mmol/L],差异均有统计学意义(均P＜0.01);用ISOGTT与改良后的ISOGTTc-pep公式计算,GDM组胰岛素敏感性均明显低于OGTT正常组[ISOGTT:(59±31)比(91±42),ISOGTTc-pep:(384±130)比(559±169)],差异均有统计学意义(均P＜0.01);在简单线性回归中,公式ISOGTTc-pep、ISHOMAc-pep、ISQUICKIc-pep与ISOGTT均明显相关(相关系数分别为0.912、-0.701、0.788,均P＜0.01),其中公式ISOGTTc-pep与ISOGTT的相关性最强.将上述变量应用到曲线模型中,幂模型为最佳模型,其相关性与简单线性回归结果相似(决定系数分别为0.889、0.712和0.690,均P＜0.01).结论 改良后的3个妊娠期胰岛素敏感性评估公式与公式ISOGTT均有明显相关性,因此可以用C肽值替代胰岛素值来评估妊娠期胰岛素敏感性,公式ISOGTTc-pep是改良后评估妊娠期胰岛素敏感性的较好指标.
目的 探討用改良後公式來評估妊娠期胰島素敏感性的可行性.方法 對納入的319名孕婦于妊娠24 ～ 32週行75 g口服葡萄糖耐量試驗(OGTT),根據診斷結果分為妊娠期糖尿病(GDM)組(47名)與OGTT正常組(272名),比較空腹和服糖後60、120 min時2組孕婦的血糖、胰島素和C肽水平.選擇妊娠期胰島素敏感性傳統評價公式ISOGTT為參攷指標併作為自變量,以用C肽替代胰島素的3箇改良後公式ISOGTTc-pep、ISHOMAc-pep和ISQUICKIc-pep為因變量,對這些因變量與白變量之間的相關性進行分析.結果 GDM組空腹、服糖後60 min與服糖後120 min時血糖水平[(4.9±1.0) mmol/L、(10.0±1.9) mmol/L、(8.5±1.9) mmol/L]均明顯高于OGTT正常組[(4.2±0.4) mmol/L、(6.9±1.4) mmol/L、(6.1±1.0) mmol/L],差異均有統計學意義(均P＜0.01);用ISOGTT與改良後的ISOGTTc-pep公式計算,GDM組胰島素敏感性均明顯低于OGTT正常組[ISOGTT:(59±31)比(91±42),ISOGTTc-pep:(384±130)比(559±169)],差異均有統計學意義(均P＜0.01);在簡單線性迴歸中,公式ISOGTTc-pep、ISHOMAc-pep、ISQUICKIc-pep與ISOGTT均明顯相關(相關繫數分彆為0.912、-0.701、0.788,均P＜0.01),其中公式ISOGTTc-pep與ISOGTT的相關性最彊.將上述變量應用到麯線模型中,冪模型為最佳模型,其相關性與簡單線性迴歸結果相似(決定繫數分彆為0.889、0.712和0.690,均P＜0.01).結論 改良後的3箇妊娠期胰島素敏感性評估公式與公式ISOGTT均有明顯相關性,因此可以用C肽值替代胰島素值來評估妊娠期胰島素敏感性,公式ISOGTTc-pep是改良後評估妊娠期胰島素敏感性的較好指標.
목적 탐토용개량후공식래평고임신기이도소민감성적가행성.방법 대납입적319명잉부우임신24 ～ 32주행75 g구복포도당내량시험(OGTT),근거진단결과분위임신기당뇨병(GDM)조(47명)여OGTT정상조(272명),비교공복화복당후60、120 min시2조잉부적혈당、이도소화C태수평.선택임신기이도소민감성전통평개공식ISOGTT위삼고지표병작위자변량,이용C태체대이도소적3개개량후공식ISOGTTc-pep、ISHOMAc-pep화ISQUICKIc-pep위인변량,대저사인변량여백변량지간적상관성진행분석.결과 GDM조공복、복당후60 min여복당후120 min시혈당수평[(4.9±1.0) mmol/L、(10.0±1.9) mmol/L、(8.5±1.9) mmol/L]균명현고우OGTT정상조[(4.2±0.4) mmol/L、(6.9±1.4) mmol/L、(6.1±1.0) mmol/L],차이균유통계학의의(균P＜0.01);용ISOGTT여개량후적ISOGTTc-pep공식계산,GDM조이도소민감성균명현저우OGTT정상조[ISOGTT:(59±31)비(91±42),ISOGTTc-pep:(384±130)비(559±169)],차이균유통계학의의(균P＜0.01);재간단선성회귀중,공식ISOGTTc-pep、ISHOMAc-pep、ISQUICKIc-pep여ISOGTT균명현상관(상관계수분별위0.912、-0.701、0.788,균P＜0.01),기중공식ISOGTTc-pep여ISOGTT적상관성최강.장상술변량응용도곡선모형중,멱모형위최가모형,기상관성여간단선성회귀결과상사(결정계수분별위0.889、0.712화0.690,균P＜0.01).결론 개량후적3개임신기이도소민감성평고공식여공식ISOGTT균유명현상관성,인차가이용C태치체대이도소치래평고임신기이도소민감성,공식ISOGTTc-pep시개량후평고임신기이도소민감성적교호지표.
Objective To evaluate the feasibility of modified indicators in assessment of insulin sensitivity in pregnant women.Methods Three hundred and nineteen women undergoing 75 g oral glucose tolerance test (OGTT) at 24 to 28 weeks of gestation were enrolled and divided into gestational diabetes mellitus (GDM) group and normal group according to the results of OGTT.The blood glucose,insulin and C peptide were measured and compared between the two groups at fasting,60 and 120 min after oral glucose load.The correlations was analyzed by taking insulin sensitivity derived from OGTT (ISOGTT) as independent variable,ISOGTTc-pep,insulin sensitivity derived from homeostasis model assessment (ISHOMAc-pep) and quantitative insulin sensitivity check index (ISQUICKIc-pep) as dependent variables out insulin being replaced by C peptide.Results The blood glucose in GDM group at fasting,60,120 min after oral glucose load were all significantly higher than those in normal group [(4.9±1.0)mmol/Lvs (4.2±0.4)mmol/L,(10.0±l.9)mmoL/L vs (6.9±l.4)mmol/L,(8.5±1.9) mmol/L vs (6.1 ± 1.0) mmol/L] (P ＜0.01).The ISOGTT and modified ISOGTTc-pep were both significantly lower in GDM group compared with those in normal group [ISOGTT:(59 ± 31) vs (91 ± 42),ISOGTTc-pep:(384 ± 130) vs (559 ± 169),all P ＜ 0.01].The ISOGTTc-pep,ISHOMAc-pep and ISQUICKIc-pep were all significantly correlated with ISOGTT in simple linear regression (r =0.912,-0.701,0.788,all P ＜ 0.01),among them the ISOGTTc-pep had the strongest correlation with ISOGTT.The power model was the best model after applying above formulas into the curve model,which got a similar outcome with the linear regression (r2 =0.889,0.712,0.690,all P ＜0.01).Conclusions The three modified formulas,ISOGTTc-pep,ISHOMAc-pep and ISQUICKIc-pep with insulin being replaced by C peptide,especial ISOGTTc-pep are all significantly correlated with ISOGTT,which are good indicators to assess the insulin sensitivity in pregnant women.
