Analysis of Insulin Secretion and Resistance in Gestational Diabetes

妊娠期糖尿病胰岛素分泌及抵抗分析

• 批准号: 11671591
• 负责人: YAMADA Hideto
• 金额: $ 2.3万
• 依托单位: Hokkaido University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11671591/
• 关键词: Gestational Diabetes; Insulin

The aim of this study was to evaluate the insulin dynamics of patients with gestational diabetes mellitus (GDM) and to compare perinatal outcomes according to the insulin response patterns. Twenty-two of consecutive 925 women examined were diagnosed as having GDM. One hundred ten women who experienced normal pregnancy were used as controls. Plasma glucose levels and insulin responses were evaluated by 2-hours 75 g OGTT. Immunoreactive insulin (IRI), area under the curves (AUC) of glucose (AUCg), AUC of insulin (AUCi), and insulinogenic index (II=ΔIRI 30'/ΔBS30') were measured. The GDM patients were divided into three subgroups, consisting of a hyper-, normo-, and hypoinsulinemia group, according to the mean ± 2SD of AUCi obtained from the controls. Clinical and laboratory findings were compared among the GDM subgroups and controls. The GDM patients showed impaired insulin secretion to glucose stimuli, with low plasma insulin levels (30') and reduced insulin/glucose ratios (30' and 60') early in 75 g OGTT. The II and AUCi/AUCg values of GDM patients were reduced as compared with those of controls. These reduced insulin responses were remarkable in hypo- and normoinsulinemic GDM patients, but were not detected in hyperinsulinemic GDM patients. The rate of large for gestational age baby in normo- and hypoinsulinemic GDM patients was significantly higher than that of hyperinsulinemic GDM patients or controls. Hyperinsulinemic GDM patients had a high frequency of pregnancy induced hypertension (40 %). Body mass index prior to pregnancy of hyperinsulinemic GDM Patients was significantly higher than that of normoinsulinemic GDM patients or controls. It was demonstrated that not only insulin secretion but also perinatal clinical characteristics differed among the GDM subgroups. The heterogeneity of the disease was thus confirmed.

本研究的目的是评估妊娠期糖尿病（GDM）患者的胰岛素动态，并根据胰岛素反应模式比较围产期结局。在连续接受检查的925名女性中，有22人被诊断患有GDM。110名正常怀孕的妇女被用作对照。通过2小时75 g OGTT评估血浆葡萄糖水平和胰岛素反应。测定免疫反应性胰岛素（IRI）、葡萄糖曲线下面积（AUC）、胰岛素曲线下面积（AUC）和胰岛素生成指数（II=ΔIRI 30′/ΔBS30′）。根据对照AUCi的平均值±2SD，将GDM患者分为高、正常、低胰岛素血症组。比较GDM亚组和对照组的临床和实验室结果。GDM患者在75 g OGTT早期表现为胰岛素分泌受损，血浆胰岛素水平低（30′），胰岛素/葡萄糖比值降低（30′和60′）。与对照组相比，GDM患者的II值和AUCi/AUCg值降低。这些胰岛素反应的降低在低胰岛素水平和正常胰岛素水平的GDM患者中是显著的，但在高胰岛素水平的GDM患者中没有发现。正常和低胰岛素血症GDM患者胎龄儿大的发生率明显高于高胰岛素血症GDM患者或对照组。高胰岛素血症型GDM患者妊娠高血压发生率高（40%）。高胰岛素血症GDM患者妊娠前体重指数明显高于正常胰岛素血症GDM患者或对照组。结果表明，GDM亚组不仅胰岛素分泌不同，围产期临床特征也不同。从而证实了该病的异质性。

项目成果

Yamada H., Kato EH., Tsuruga R., et al.: "Insulin response patterns contribute to different perinatal risks in gestational diabetes"Gynecol Obstct Invest. 51・2. 103-109 (2001)

Yamada H.、Kato EH.、Tsuruga R. 等：“胰岛素反应模式导致妊娠期糖尿病的不同围产期风险”Gynecol Obstct Invest. 103-109 (2001)。

Hideto Yamada: "Insulin response patterns contribute to different perinatal risks in gestational diabetes "Gyuecol Obstet Inrest. (印刷中). (2001)

Hideto Yamada：“胰岛素反应模式导致妊娠期糖尿病的不同围产期风险”Gyuecol Obstet Inrest（2001 年出版）。

Yamada H, et al.: "Insulin response patterns contribute to different perinatal risks in gestational diabetes"Gynecol Obstet Invest. 51.2. 103-109 (2001)

Yamada H 等人：“胰岛素反应模式导致妊娠期糖尿病的不同围产期风险”Gynecol Obstet Invest。

Yamada H, Kato EH, Tsuruga R, Ebina Y, Kobashi G, Sagawa T, Makita Z, Koike T, Fujimoto S: "Insulin response patterns contribute to different perinatal risks in gestational diabetes"Gynecol Obstet Invest. 51(2). 103-109 (2001)

Yamada H、Kato EH、Tsuruga R、Ebina Y、Kobashi G、Sakawa T、Makita Z、Koike T、Fujimoto S：“胰岛素反应模式导致妊娠期糖尿病的不同围产期风险”Gynecol Obstet Invest。