| 87 | 3 | 22 |
| 下载次数 | 被引频次 | 阅读次数 |
目的:探讨妊娠糖尿病(GDM)产后糖调节功能受损者(IGR)行生活方式干预前后血糖血脂、胰岛素水平、胰岛β细胞功能状态及胰岛抵抗作用的变化情况。方法:对在本院分娩的285例GDM患者于产后68周行糖耐量试验测试,将筛选出的65例空腹血糖调节受损(IFG)或糖耐量测试阳性者随机分为观察组33例以及对照组32例,其中观察组患者接受为期2年的生活干预,对照组患者发放糖尿病宣传资料,对比分析两组患者干预前后血糖血脂、胰岛素水平、胰岛β细胞功能状及胰岛抵抗作用的变化情况。结果:观察组干预后空腹血糖(FPG)、餐后2h血糖(2hFPG)、糖化血糖蛋白(HbAlc)、总胆固醇(TC)、甘油三脂(TG)、低密度蛋白(LDL-C)低于对照组,而高密度蛋白(HDL-C)高于对照组,差异有统计学意义(P<0.05)。观察组治疗后稳态模型胰岛素抵抗指数(HoMA-IR)、空腹胰岛素(FIns)、餐后2h胰岛素(2hFIns)及B细胞功能指数高于对照组,差异有统计学意义(P<0.05)。结论:对GDM产后IGR异常患者行生活方式干预能有效降低患者血糖血脂水平,改善患者胰岛β细胞功能状态及胰岛抵抗作用,增加胰岛素敏感性。
Abstract：Objective:To investigate changes of blood glucose,insulin levels,pancreaticβ-cell function and insulin resistant status in patients with postpartum impaired glucose regulation(IGR)following gestational diabetes mellitus(GDM).Methods:Of 285GDM patients who underwent glucose tolerance test 6-8weeks after delivery,65cases that were diagnosed as IFG or got positive results were selected as observation group(n=33cases)and control group(n=32cases).The observation group was intervened with lifestyle regulation for 2years,while the control group was given related education.Blood glucose,insulin levels,pancreaticβ-cell function and insulin resistant status were observed and compared.Results:The levels of fasting plasma glucose(FPG),2hpostprandial blood glucose(2hFPG),glycated blood protein(HbAlc),total cholesterol(TC),triglyceride(TG),low-density protein(LDL-C)of observation group were lower than that of the control group,while the levels of high-density protein(HDL-C) were higher than control group,the difference was statistically significant(P<0.05).The homeostasis model assessment of insulin resistance index(HoMA-IR),fasting insulin(FIns),2hpostprandial insulin(2hFIns)and B-cell function index of the observation group were higher than control group(P<0.05).Conclusion:Lifestyle interventions can effectively reduce blood glucose and lipid levels in patients with postpartum IGR following GDM.It can improve isletβcell function,decrease insulin resistance,but increase insulin sensitivity.
1 余筱燕,吴雪梅,张毅,等.生活方式干预对妊娠糖尿病产后糖调节受损者胰岛素抵抗和胰岛β细胞功能的影响[J].中国慢性病预防与控制,2012,20(5):560-562.
2 谭小燕.妊娠糖尿病患者产后家庭护理干预相关研究进展[J].中国临床新医学,2012,05(10):990-992.
3 廖晓焰,贺娟,扎西等.妊娠期糖尿病不同筛查方法和诊断标准与妊娠结局的关系[J].成都医学院学报,2012,7(4):594-595.
4 郑琳.护理干预对妊娠糖尿病患者的影响研究[J].实用心脑肺血管病杂志,2012,20(11):1892.
5 赖丽萍,陆泽元,李翠吟,等.GAD-Ab阳性的妊娠糖尿病患者胰岛素敏感性与β细胞功能变化[J].实用预防医学,2012,19(4):503-506.
6 Wang T,Lu J,Xu Y,et al.Circulating prolactin associates with diabetes and impaired glucose regulation:a population-based study[J].Diabetes Care,2013,36(7):1974-1980.
7 Demirci C,Ernst S,Alvarez-Perez JC,et al.Loss of HGF/c-Met signaling in pancreaticβ-cells leads to incomplete maternalβ-cell adaptation and gestational diabetes mellitus[J].Diabetes,2012,61(5):1143-1152.
8 吴正林,何涛君,侯学荣,等.孕妇在不同糖耐量状态下胰岛β细胞分泌功能和胰岛素抵抗与C肽的关系研究[J].现代检验医学杂志,2012,27(4):53-54,57.
9 Tam WH,Ma RC,Yang X,et al.Cardiometabolic risk in Chinese women with prior gestational diabetes:a 15-year follow-up study[J].Gynecol Obstet Invest,2012,73(2):168-176.
10 Lee KF,Mak MW,Lau KO,et al.Risk of development of diabetes mellitus in Chinese women with persistently impaired glucose tolerance after gestational diabetes[J].Hong Kong Med J,2011,17(3):195-201.
11 刘长江,王颜刚.妊娠期糖尿病胰岛α细胞、β细胞功能评估[J].中华内分泌代谢杂志,2012,28(10):835-838.
12 Zhang H,Zhang J,Pope CF,et al.Gestational diabetes mellitus resulting from impaired beta-cell compensation in the absence of FoxM1,a novel downstream effector of placental lactogen[J].Diabetes,2010,59(1):143-152.
13 苏珂,龙艳,李雄,等.妊娠糖尿病子代红细胞膜胰岛素受体与胰岛素抵抗的关系[J].中国妇幼保健,2011,26(2):258-260.
14 余欣庭,黎明,孙秀静,等.妊娠糖尿病母亲母乳中真胰岛素水平及对婴儿生长的影响[J].中国新生儿科杂志,2011,26(3):154-158.
基本信息:
DOI：10.13210/j.cnki.jhmu.20131219.008
中图分类号:R587.1
引用信息:
[1]蒋仕祥,杜小蓉.生活方式干预对GDM患者产后IGR胰岛素抵抗及胰岛β细胞功能状态的影响[J].海南医学院学报,2014,20(03):405-408.DOI:10.13210/j.cnki.jhmu.20131219.008.
基金信息:
深圳市宝安区科技计划项目(2013282)~~
2014-03-28
2014-03-28