The metabolic effects of pregnancy in cystic fibrosis
The metabolic effects of pregnancy in cystic fibrosis
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DOI：
10.1097/01.aog.0000172421.04007.74
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发表时间：
2005-08-01
影响因子：
7.2
通讯作者：
Nick, JA
中科院分区：
文献类型：
--
作者：
Hardin, DS;Rice, J;Nick, JA
目的：我们的目的是确定糖耐量与囊性纤维化（CF）的孕妇和葡萄糖耐量与胰岛素敏感性，肝葡萄糖生产，和蛋白质turning.Methods：我们研究了8个CIF妇女在怀孕期间（CFPreg）。并与9例妊娠对照组（PregCont）和8例非妊娠CF组（CFCont）进行比较。进行了以下代谢研究：口服葡萄糖耐量试验（OGTT）、高胰岛素正葡萄糖钳夹、[1- 13 C]亮氨酸和[6，6 - 2 H（2）]葡萄糖稳定同位素输注，分别用于测量全身蛋白质周转和肝葡萄糖生成（HGP）。采用间接量热法测量静息能量消耗（REE），通过3天食物日志测量食物摄入量。无脂肪质量测量全身钾40 K扫描。结果：除了一个CFPreg开发糖尿病的第二个三个月结束时，有显着降低胰岛素分泌和更多的胰岛素抵抗比PregCont。CF患者的肝脏葡萄糖生成显著较高，胰岛素抑制较少，蛋白质分解显著较高。胰岛素抵抗和HGP增加在怀孕期间同样CFPreg和PregCont groups.Conclusion：妊娠CF与胰岛素敏感性下降和高HGP，除了固有的胰岛素分泌减少。妊娠CIF也与蛋白质周转增加和对胰岛素抗分解作用的反应较低有关。这些变化似乎使怀孕的CF妇女更容易早期患糖尿病和体重增加不良。
Objective: Our purpose was to determine glucose tolerance in pregnant women with cystic fibrosis (CF) and to relate glucose tolerance to insulin sensitivity, hepatic glucose production, and protein turnover.Methods: We studied 8 CIF women during pregnancy (CFPreg). Results were compared with those from 9 pregnant controls (PregCont) and 8 nonpregnant CF women (CFCont). The following metabolic studies were conducted: oral glucose tolerance test (OGTT), hyperinsulinemic euglycemic clamp, stable isotope infusion of [1-13C] leucine and [6,6-2H(2)] glucose for measurement of whole body protein turnover and hepatic glucose production (HGP), respectively. Indirect calorimetry was used to measure resting energy expenditure (REE), and food intake was measured by 3-day food journals. Fat-free mass was measured by total body potassium 40K scan.Results: All but one CFPreg developed diabetes by the end of the second trimester and had significantly lower insulin secretion and more insulin resistance than PregCont. Hepatic glucose production was significantly higher and suppression by insulin was less in CF subjects, and protein breakdown was significantly higher. Insulin resistance and HGP increased during pregnancy similarly in CFPreg and PregCont groups.Conclusion: Pregnancy in CF is associated with decreased insulin sensitivity and high HGP, in addition to inherent decreased insulin secretion. Pregnancy in CIF is also associated with increased protein turnover and less response to insulin's anticatabolic effect. These changes appear to predispose the pregnant CF women to early development of diabetes and poor weight gain.