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目的探讨妊娠晚期胰岛素抵抗与血清铁蛋白(SF)浓度的关系及其在妊娠期糖尿病(GDM)发病中的作用。方法选择2014年1月-2015年12月浙江大学明州医院收治的80例GDM孕妇作为GDM组,80例糖耐量正常孕妇作为对照组。测定血清SF、血红蛋白(Hb)、糖化血红蛋白(Hb Alc)、空腹血糖(FPG)、餐后1 h血糖、餐后2 h血糖、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌功能指数(HBCI)。结果 GDM组血清SF[(51.31±26.45)μg/L]、Hb[(123.41±9.76)g/L]、HbAlc[(6.53±1.46)%]水平均高于对照组,两组比较,差异有统计学意义(P<0.05)。GDM组FPG[(5.93±0.18)mmol/L]、餐后1 h血糖[(11.53±0.54)mmol/L]、2 h血糖[(9.02±0.28)mmol/L]、HOMA-IR[(4.71±0.57)%]、HBCI[(8.93±0.14)%]均高于对照组,两组比较,差异有统计学意义(P<0.05)。GDM组HOMA-IR与血清SF呈正相关(P<0.05),对照组HOMA-IR与血清SF无相关性(P>0.05)。结论 GDM患者血清SF水平升高和HOMA-IR呈正相关。在临床治疗中,对血清SF水平进行监测,血清SF不足者予以补充。
Objective To investigate the relationship between late pregnancy insulin resistance and serum ferritin (SF) concentration and its role in the pathogenesis of gestational diabetes mellitus (GDM). Methods From January 2014 to December 2015, 80 pregnant women with GDM admitted to Mingzhou Hospital of Zhejiang University were enrolled as GDM group and 80 pregnant women with normal glucose tolerance as control group. Serum SF, hemoglobin, Hb Alc, fasting blood glucose (FPG), 1 h postprandial blood glucose, 2 h postprandial blood glucose, insulin resistance index (HOMA-IR), pancreatic β-cell secretory function index HBCI). Results The levels of serum SF [(51.31 ± 26.45) μg / L], Hb [(123.41 ± 9.76) g / L] and HbAlc [(6.53 ± 1.46)%] in GDM group were significantly higher than those in control group Statistical significance (P <0.05). (5.93 ± 0.18) mmol / L], postprandial 1 h blood glucose [(11.53 ± 0.54) mmol / L], 2 h blood glucose [(9.02 ± 0.28) mmol / L] and HOMA-IR [(4.71 ± 0.57)%] and HBCI [(8.93 ± 0.14)%], respectively. The difference between the two groups was statistically significant (P <0.05). There was a positive correlation between HOMA-IR and serum SF in GDM group (P <0.05). There was no correlation between HOMA-IR in control group and serum SF (P> 0.05). Conclusion The serum level of SF in GDM patients is positively correlated with HOMA-IR. In clinical treatment, the level of serum SF monitoring, serum SF are not enough to be supplemented.