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目的探讨妊娠期糖尿病(GDM)患者血清雌二醇水平与胰岛素抵抗的相关性。方法采集妊娠晚期107例正常孕妇(A组)和103例GDM孕妇(B组)外周血。用ELISA法检测血清17β-雌二醇水平,并检测空腹血糖(FBG)及空腹胰岛素(FIns)水平。应用稳态模式评估法计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(HOMA-ISI),分析血清17β-雌二醇表达与HOMA-IR、HOMA-ISI的相关性。结果与A组相比,B组血清17β-雌二醇、FBG和FIns水平以及HOMA-IR升高(P<0.05或P<0.01),而HOMA-ISI降低(P<0.01)。血清17β-雌二醇水平与HOMA-IR呈正相关(r=0.787,P<0.01),而与HOMA-ISI呈负相关(r=-0.765,P<0.01)。结论雌激素可能参与了GDM的病理生理过程;血清雌激素水平升高导致的胰岛素抵抗可能是GDM的发病机制之一。
Objective To investigate the relationship between serum estradiol level and insulin resistance in patients with gestational diabetes mellitus (GDM). Methods 107 normal pregnant women (group A) and 103 pregnant women with GDM (group B) peripheral blood were collected in the third trimester of pregnancy. Serum 17β-estradiol level was detected by ELISA and fasting blood glucose (FBG) and fasting insulin (FIns) levels were measured. HOMA-IR and HOMA-ISI were calculated using steady-state model. The correlation between serum 17β-estradiol expression and HOMA-IR and HOMA-ISI was analyzed. Results Compared with group A, the serum levels of 17β-estradiol, FBG and FIns and HOMA-IR in group B were significantly increased (P <0.05 or P <0.01), while the levels of HOMA-ISI were decreased in group B (P <0.01). Serum 17β-estradiol level was positively correlated with HOMA-IR (r = 0.787, P <0.01), but negatively correlated with HOMA-ISI (r = -0.765, P <0.01). Conclusion Estrogen may be involved in the pathophysiology of GDM. Insulin resistance induced by elevated serum estrogen levels may be one of the pathogenesis of GDM.