Clinically useful estimates of insulin sensitivity during pregnancy - Validation studies in women with normal glucose tolerance and gestational diabetes mellitus
Clinically useful estimates of insulin sensitivity during pregnancy - Validation studies in women with normal glucose tolerance and gestational diabetes mellitus
复制标题
DOI：
10.2337/diacare.24.9.1602
复制
发表时间：
2001-09-01
期刊：
影响因子：
16.2
通讯作者：
Catalano, PM
中科院分区：
文献类型：
--
作者：
Kirwan, JP;Huston-Presley, L;Catalano, PM
目的-我们检查是否选择胰岛素敏感性的指数从口服葡萄糖耐量试验（ISOGTT）或空腹血糖/胰岛素水平（ISQUICKI和ISHOMA）来预测胰岛素敏感性的妇女在怀孕前和怀孕期间，研究设计和方法-2小时正常血糖高胰岛素钳夹（5 mmol/l葡萄糖，40 mU。m（-2）。对15名孕妇（10名糖耐量正常（NGT），5名妊娠期糖尿病（GDM））在妊娠早期（12-14周）和妊娠晚期（34-36周）进行了120分钟口服葡萄糖耐量试验（75负荷，妊娠100 g）。从葡萄糖输注速率中获得了一个由钳夹产生的胰岛素敏感性指数，该葡萄糖输注速率针对无脂肪质量的变化和使用[6，6-H-2（2）]葡萄糖测量的内源性葡萄糖产生进行了调整。结果-使用组合组和妊娠期的单变量分析导致了ISclamp和ISOGTT之间的显著相关性（r（2）= 0.74，P < 0.0001），ISQUICKI（r（2）= 0.04 P < 0.0001）和ISHOMA（r（2）= 0.53 P < 0.0001）。ISOGTT提供了比ISQUICKI或ISHOMA显著更好的相关性（P < 0.0001）。多变量分析显示预测模型具有显著的组效应（p < 0.0003），并为NGT（r（2）= 0.64，P < 0.0001）和GDM（r（2）= 0.85，P < 0.0001）组开发了单独的方程。按妊娠期细分，ISCLAMP与妊娠前ISOGTT的相关性为r（2）= 0.63（P = 0.0002），在孕早期r（2）= 0.80孕晚期与对照组比较，r（2）= 0.64（P = 0.0002），结论-妊娠期间ISOGTT对胰岛素敏感性的估计明显优于空腹血糖和胰岛素值。然而，单独的预测方程是必要的孕妇NGT和妇女GDM。
OBJECTIVE - We examined whether selected indexes of insulin sensitivity derived from an oral glucose tolerance test (ISOGTT) or fasting glucose/insulin levels (ISQUICKI and ISHOMA be used to predict insulin sensitivity in women before and during pregnancy,RESEARCH DESIGN AND METHODS - A 2-h euglycemic-hyperinsulinemic clamp (5 mmol/l glucose, 40 mU . m(-2) . min(-1) insulin) and a 120-min oral glucose tolerance test (75 load pregravid, 100 g pregnant) were repeated on 15 women (10 with normal glucose tolerance [NGT] and 5, with gestational diabetes mellitus [GDM]) pregravid and during both early (12-14 weeks) and late (34-36 weeks) pregnancy. An index of insulin sensitivity derived from the clamp was obtained from glucose infusion rates adjusted for change in fat-free mass and endogenous glucose production measured using [6,6-H-2(2)] glucose.RESULTS- Univariate analysis using combined groups and periods of pregnancy resulted in significant correlations between ISclamp and ISOGTT (r(2) = 0.74, P < 0.0001), ISQUICKI (r(2) = 0.04 P < 0.0001), and ISHOMA (r(2) = 0.53, P < 0.0001). The ISOGTT provided a significantly better correlation (P < 0.0001) than either ISQUICKI or ISHOMA Multivariate anal is showed a significant group effect (p < 0.0003) on the prediction model, and separate equations were developed for the NGT (r(2) = 0.64, P < 0.0001) and GDM (r(2) = 0.85, P < 0.0001) groups. When subdivided by period of pregnancy, the correlation between ISCLAMP and ISOGTT pregravid was r(2) = 0.63 (P = 0.0002), during early pregnancy was r(2) = 0.80 (p < 0.0001) and during late pregnancy was r(2) = 0.64 (P = 0.0002),CONCLUSIONS - Estimates of insulin sensitivity from the ISOGTT during pregnancy were significantly better than from fasting glucose and insulin values. However, separate prediction equations are necessary for pregnant women with NGT and women with GDM.