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目的:探讨妊娠糖尿病(GDM)子代红细胞膜胰岛素受体与胰岛素抵抗之间的关系。方法:32例妊娠糖尿病患者的儿童,22例正常妊娠者的儿童,测定空腹血糖(FBG)、空腹胰岛素(FINS)、餐后2 h血糖(2h BG)、餐后2 h胰岛素(2 h INS)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL),并检测高、低亲和力红细胞膜胰岛素受体数目(R1、R2)和亲和力常数(K1、K2),计算胰岛素抵抗指数(IRI)。结果:GDM组儿童R1、R2低于对照组(P<0.05);GDM组儿童体重、BMI、FINS水平高于正常对照组(P<0.05)。多元线性逐步回归分析结果显示,进入回归方程的因素有体重(t=32.186,P<0.05)、BMI(t=3.362,P<0.05)、R1(t=-2.613,P<0.05)、R2(t=-2.541,P<0.05),提示以上因素是影响GDM组儿童IR的主要危险因素。结论:妊娠糖尿病(GDM)子代存在胰岛素抵抗,且与红细胞膜胰岛素受体数目减少、亲和力下降及体重指数有密切关系。
Objective: To investigate the relationship between insulin receptor and erythrocyte insulin receptor in gestational diabetes mellitus (GDM) offspring. Methods: 32 children with gestational diabetes mellitus and 22 normal pregnancy children were enrolled in this study. Fasting blood glucose (FBG), fasting insulin (FINS), postprandial 2h blood glucose (2h BG), postprandial 2h insulin (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), and the number of high and low affinity erythrocyte insulin receptors (R1, R2) and affinity constants (K1, K2), calculate the insulin resistance index (IRI). Results: The levels of R1 and R2 in GDM group were lower than those in control group (P <0.05). The body weight, BMI and FINS in GDM group were higher than those in control group (P <0.05). Multivariate linear stepwise regression analysis showed that the factors that entered the regression equation were body weight (t = 32.186, P <0.05), BMI (t = 3.362, t = -2.541, P <0.05), suggesting that the above factors are the major risk factors for IR in children with GDM. CONCLUSION: There is insulin resistance in gestational diabetes mellitus (GDM) offspring, and it is closely related to the decrease of insulin receptor number, the decrease of affinity and the body mass index of erythrocyte membrane.