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目的研究妊娠期糖代谢与胰升血糖素样肽-1(GLP-1)的关系。方法选取妊娠26~28周的孕妇及未孕育龄妇女90名,分为GDM组30例、糖耐量正常妊娠组(GNGT)30名及糖耐量正常未孕组(NGT)30名。检测各组75 g OGTT各时点(0 h、1 h、2 h)血清葡萄糖、胰岛素及GLP-1水平,并测量体重、血压及血脂水平。结果 GDM组GLP-1水平最低,NGT组最高。3组1 hGLP-1水平、1 hIns分泌指数(△Ins/△PG)及1 hGLP-1分泌指数(△GLP-1/△PG)比较,差异有统计学意义(P<0.05)。多元线性回归分析显示,孕期体重和HOMA-IR是妊娠期GLP-1的影响因素,HOMA-IR、FIns和GLP-1是妊娠期FPG的影响因素。结论妊娠期GLP-1水平下降,餐后反应下降,GDM者下降更为明显;GLP-1影响妊娠期糖代谢,可能参与了GDM的发生。
Objective To study the relationship between gestage sugar metabolism and glucagon-like peptide-1 (GLP-1). Methods Totally 90 pregnant and nonpregnant women of 26-28 weeks of gestation were selected and divided into 30 cases of GDM group, 30 normal glucose tolerance group (GNGT) and 30 normal glucose tolerance group (NGT). Serum glucose, insulin and GLP-1 levels were measured at 75 g OGTT at each time point (0 h, 1 h, 2 h) in each group. Body weight, blood pressure and blood lipid levels were measured. Results The lowest level of GLP-1 in GDM group and the highest in NGT group. The levels of 1 hGLP-1, 1 hIns secretion index (△ Ins / △ PG) and 1 hGLP-1 secretion index (△ GLP-1 / △ PG) in the three groups were significantly different (P <0.05). Multivariate linear regression analysis showed that body weight and HOMA-IR during pregnancy were the influencing factors of GLP-1 in pregnancy. HOMA-IR, FIns and GLP-1 were the influencing factors of FPG during pregnancy. Conclusions The level of GLP-1 in pregnancy is decreased, the postprandial reaction is decreased, and the decline in GDM is more obvious. GLP-1 affects the glucose metabolism in pregnancy and may be involved in the occurrence of GDM.