Insulin resistance and β-cell function influence postprandial blood glucose levels in Japanese patients with gestational diabetes mellitus
Insulin resistance and β-cell function influence postprandial blood glucose levels in Japanese patients with gestational diabetes mellitus
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DOI：
10.3109/09513590.2015.1075498
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发表时间：
2015-12-02
影响因子：
2
通讯作者：
Namba, Mitsuyoshi
中科院分区：
文献类型：
--
作者：
Kusunoki, Yoshiki;Katsuno, Tomoyuki;Namba, Mitsuyoshi
目的/简介：本研究的目的是评估妊娠糖尿病（GDM）患者胰岛素抵抗和分泌与传感器下面积葡萄糖浓度-时间曲线(CGM- auc （0-120) (min)）的关系，该曲线由连续血糖监测（CGM）测定。材料和方法：对22例日本GDM患者进行75 g口服糖耐量试验，检测免疫反应性胰岛素和HbA1c。患者在接受GDM诊断后3周内接受CGM。结果：HbA1c （NGSP）为5.5 +/- 0.4%，BMI为24.8 +/- 5.3 kg/m(2)， CGM平均传感器葡萄糖为94.2 +/- 10.3 mg/dL，标准差为17.5 +/- 4.4 mg/dL, CGM- auc (0-120) （min）为204.2 +/- 23.8 h mg/dL。胰岛素抵抗指标、稳态模型评估比（HOMA-R）、胰岛素敏感性定量检查指数（QUICKI）、Matsuda指数与CGM-AUC(0-120) （min）相关。用于评价胰岛素分泌的处置指数（DI）与CGM-AUC(0-120) （min）呈负相关。结论：日本GDM患者餐后高血糖不仅与胰岛素抵抗有关，还与β细胞功能障碍有关。
Aims/introduction: The aim of this study in patients with gestational diabetes mellitus (GDM) was to evaluate the relationship of insulin resistance and secretion to area-under-the-sensor glucose concentration-time curve from before to 120 min postmeal (CGM-AUC(0-120) (min)) as determined with continuous glucose monitoring (CGM).Materials and methods: Immunoreactive insulin and HbA1c were determined in 22 Japanese patients with GDM undergoing a 75 g oral glucose tolerance test. Patients underwent CGM within 3 weeks of receiving a diagnosis of GDM.Results: HbA1c (NGSP) was 5.5 +/- 0.4%, BMI was 24.8 +/- 5.3 kg/m(2), mean sensor glucose by CGM was 94.2 +/- 10.3 mg/dL, standard deviation was 17.5 +/- 4.4 mg/dL, and CGM-AUC(0-120) (min) was 204.2 +/- 23.8 h mg/dL. The insulin resistance indices the homeostasis model assessment ratio (HOMA-R), quantitative insulin sensitivity check index (QUICKI), and the Matsuda Index were correlated with CGM-AUC(0-120) (min). The disposition index (DI), which was used to evaluate insulin secretion, was negatively correlated with CGM-AUC(0-120) (min).Conclusions: Not only insulin resistance but also beta cell dysfunction contributes to postprandial hyperglycemia in Japanese patients with GDM.