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目的通过观察妊娠期糖尿病(GDM)患者空腹血清游离脂肪酸(FFA)水平及胰岛素抵抗指数(HOMA-IR)值变化,探讨FFA与GDM患者胰岛素抵抗(IR)的关系。方法以同期GDM组(67例)、正常孕妇组(40例)及正常非孕组(40例)为研究对象。酶联法检测空腹血清FFA水平,同时检测空腹血糖(FBG)、空腹胰岛素(Fins)水平,计算HOMA-IR值。结果 GDM组血清FPG、Fins、FFA水平及HOMA-IR值均显著高于正常非孕组及正常孕妇组(P<0.01),正常孕妇组血清Fins、FFA水平及HOMA-IR值均显著高于正常非孕组(P<0.01),但血清FPG无显著性差异(P>0.05)。GDM患者空腹血清FFA水平与HOMA-IR值呈显著正相关(r=0.709,P<0.01),其相关性良好。结论GDM患者体内存在着高FFA血症及IR状态,FFA水平与IR相关,此为早期干预GDM的发生发展提供了理论依据。
Objective To investigate the relationship between FFA and insulin resistance (IR) in GDM patients by observing the changes of fasting serum free fatty acid (FFA) and insulin resistance index (HOMA-IR) in patients with gestational diabetes mellitus (GDM). Methods GDM group (67 cases), normal pregnant women group (40 cases) and normal non-pregnant group (40 cases) were studied. Fasting serum FFA levels were detected by enzyme-linked immunosorbent assay (FFA), fasting blood glucose (FBG) and fasting insulin (Fins) levels were measured simultaneously to calculate HOMA-IR. Results The levels of FPG, Fins, FFA and HOMA-IR in GDM group were significantly higher than those in normal non-pregnant group and normal pregnant women (P <0.01). The levels of serum Fins, FFA and HOMA-IR in normal pregnant women were significantly higher than those in normal pregnant women Normal non-pregnant group (P <0.01), but no significant difference in serum FPG (P> 0.05). Fasting serum FFA levels in GDM patients were positively correlated with HOMA-IR (r = 0.709, P <0.01), and the correlation was good. Conclusions There is hyperfcemia and IR status in GDM patients. The level of FFA is related to IR, which provides a theoretical basis for the early intervention of GDM.