妊娠期糖尿病患者血浆胰岛素和C肽水平变化

Level changes of insulin and C-peptide in pregnancy of gestational diabetes mellitus

关键词:  糖尿病  妊娠  胰岛素  C肽

Key words:  diabetes  gestational  insulin  C-peptide

摘要:

了解妊娠期胰岛细胞的功能状况，探讨胰岛素、C肽水平检测诊断妊娠期糖尿病(GDM)及妊娠期糖耐量减低(IGT)的意义。方法： 用时间分辨荧光法测定对GDM患者（A组，53例）、IGT患者（B组，60例）、正常妊娠妇女（C组，50例）及正常非妊娠妇女（D组，50例）的胰岛素和C肽水平及变化。结果： (1)孕晚期C组孕妇血清中胰岛素、C肽水平开始上升并明显高于D组(P<0.01)，产时出现蜂式分泌高峰；(2)胰岛素水平孕28-34周时A、B组明显高于C组(P<0.01)，而孕38～40周时略有下降；(3)孕28～34周时A组C肽水平明显高于B、C组(P<0.01)，而产时明显低于C组(P<0.01)，产后A、B组仍明显高于C组(P<0.05)。结论： 孕28～34周GDM病人胰岛素和C肽出现显著高于正常妊娠胰岛素水平的小峰，在孕晚期可帮助GDM诊断，小峰的出现可能与组织的胰岛素敏感性有关

Abstract:

To understand the β-cell function in gestational and interpret the diagnostic significance of plasma insulin and c-peptide on gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (IGT). Method: Test the plasma insulin and c-peptide in 53 cases of GDM (group A), 60 cases of IGT (group B), 50 cases of normal pregnant women (group C) and 50 cases of healthy non-pregnant women (group D). Results: (1) In the third trimester insulin, c-peptide levels of group C were higher than the of group D (P<0.01). They increased and peaked during delivery. (2) At 28～34 insulin levels of group A and B were higher than those of group C (P<0.01), but tend to decrease by the end the third trimester and peaked during delivery. (3) At 28～34 weeks, c-peptide of group A were significantly higher than those in the group B and C (P<0.01) and were lower than that in group C during delivery (P<0.05). Insulin and c-peptide of groups A, B and C dropped gradually within 2 months after delivery, but in group A and B they were significantly higher than those of group C (P<0.01). Conclusions: In the third trimester insulin and c-peptide of group A, B had small peaking secretion. The phenomena could help to diagnose GDM in the third trimester. The reason maybe associated with the tissue susceptibility to insulin