妊娠糖尿病患者血清Nesfatin-1与胰岛素抵抗及胰岛细胞功能的相关性研究
Serum nesfatin-1 levels in gestational diabetes mellitus in relation to insulin resistance and pancreatic β-cell function
探讨妊娠糖尿病患者胰岛素抵抗、胰岛细胞功能与空腹血清Nesfatin-1之间的关系.选取妊娠24~ 28周孕妇90例,根据口服葡萄糖耐量试验(OGTT)结果分为妊娠糖尿病组(GDM) 45例,糖耐量正常组45例,并以空腹血糖(FPG) 7.0 mmol/L为切割点,将GDM组分为GDM1组和GDM2组.检测各组空腹血清Nesfatin-1水平,同时测定OGTT各点血糖、胰岛素和C肽等,并计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、胰岛素曲线下面积(INSAUC)/血糖曲线下面积(PGAUC)和早期胰岛素分泌功能指数,分析Nesfatin-1与这些指标之间的关系.GDM1组和GDM2组的Nesfatin-1水平均显著高于对照组(P<0.01);GDM2组的Nesfatin-1水平高于GDM1组(P<0.05).Pearson相关分析显示,Nesfatin-1与FPG,30 min血糖、1h血糖、2h血糖、HOMA-IR、PGAUC正相关,与HOMA-β负相关.多元逐步回归分析显示,FPG是影响Nesfatin-1水平的独立相关因素.Nesfatin-1与胰岛素抵抗正相关,与胰岛细胞功能负相关,其可能在妊娠糖尿病的发病机制中发挥一定的作用.
更多The association of serum nesfatin-1 levels with insulin resistance and pancreatic β-cell function in gestational diabetes mellitus was investigated.Oral glucose tolerance test(OGTT) was performed in ninety pregnant women from 24,to 28 gestational weeks.They were divided into three groups according to OGTT:45 nomal controls,27 gestational diabetes mellitus with fasting plasma glucose (FPG) of 5.1 mmol/L to 7.0 mmol/L (GDM1),18 gestational diabetes mellitus with FPG more than 7.0 mmol/L (GDM2).Serum nesfatin-1 levels were significantly higher in patients with GDM1 and GDM2 than in controls (P<0.01),and in GDM2 group it was also higher than GDM1 group(P<0.05).Fasting serum nesfatin-1 was positively correlated with FPG,30 min plasma glucose,1 h plasma glucose,2 h plasma glucose,homeostasis model assessment for insulin resistance,and PGAUC,but negatively correlated with homeostasis model assessment for β-cell function.Furthermore,multiple stepwise regression analysis showed that FPG was the independent influencing factor of serum nesfatin-1 level.Nesfatin-1 was positively correlated with insulin resistance,while negatively correlated with pancreatic β-cell function.Nesfatin-1 may play a role in the pathogenesis of gestational diabetes mellitus.
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