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目的研究初次妊娠未发生妊娠期糖尿病(gestational diabetes mellitus,GDM)的育龄期妇女在二次妊娠发生GDM时年龄对胰岛素抵抗(insulin resistance,IR)及胰岛β细胞功能的影响。方法选取2013年8月至2014年8四川省人民医院产科门诊139例初次妊娠时糖尿病耐量正常二次妊娠诊断为GDM的患者,按年龄分为高龄组(≥35岁,65例)和低龄组(<35岁,74例)。比较两组患者GDM筛查时和产后6周的空腹血糖(fasting blood glucose,FBG)、空腹胰岛素水平,HOMA-IR,胰岛β细胞分泌指数(HOMA-IS)及产后6周血糖恢复情况。结果高龄组分娩前后FBG、空腹胰岛素(fasting insulin,FINS)、HOMA-IR水平以及产后遗留血糖异常率高于低龄组,而HOMA-IS较低(P<0.05)。结论 GDM患者围产期高龄组较低龄组胰岛素抵抗更重,胰岛细胞功能更差,产后遗留血糖异常比例更高。
Objective To investigate the effects of age on insulin resistance (IR) and islet β-cell function in women of childbearing age without gestational diabetes mellitus (gestational diabetes mellitus) in the first trimester of pregnancy. Methods From August 2013 to August 2014, 139 patients diagnosed as GDM with first trimester of pregnancy with gestational diabetes at the obstetric clinic of Sichuan Provincial People’s Hospital were divided into the elderly group (≥35 years old, 65 cases) and the younger age group (<35 years old, 74 cases). Fasting blood glucose (FBG), fasting insulin level, HOMA-IR, HOMA-IS and postprandial blood glucose recovery were compared between the two groups at GDM screening and 6 weeks postpartum. Results The FBG, fasting insulin (FINS), HOMA-IR levels and postpartum residual blood glucose in the elder group were higher than those in the younger group and lower in HOMA-IS (P <0.05). Conclusion The GDM patients with perinatal age group had more insulin resistance, islet cell function worse, and the proportion of postpartum residual blood glucose abnormality was higher.