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目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)妇女空腹血清成纤维细胞生长因子(fibroblast growth factors,FGFs)19、21水平与胰岛素抵抗的相关性及影响血清FGF-19、FGF-21水平的主要因素。方法选取2015年9月至2016年4月在华北理工大学附属医院就诊的孕妇115例,根据其口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果正常与否分为GDM组55例和对照组60例。分别对其一般资料、空腹血清FGF-19、FGF-21、空腹血糖、空腹胰岛素水平、胰岛素抵抗指数(insulin resistance,HOMA-IR)、胰岛β细胞功能指数(islet beta cell function,HOMA-β)等相关指标进行分析。结果 GDM组空腹血糖、空腹胰岛素、HOMA-IR、FGF-21高于对照组,差异均有统计学意义(P<0.05),GDM组FGF-19水平、HOMA-β低于对照组,差异有统计学意义(P<0.05);血清FGF-19与孕前体质量指数、空腹血糖、空腹胰岛素、HOMA-IR、FGF-21呈负相关(P<0.05),与HOMA-β呈正相关(P<0.05),血清FGF-21与孕前体质量指数、空腹血糖、空腹胰岛素、HOMA-IR呈正相关(P<0.05),与HOMA-β、FGF-19呈负相关(P<0.05);多元逐步线性回归分析:空腹血糖、HOMA-IR、空腹胰岛素是影响血清FGF-19水平的主要因素,空腹血糖是影响血清FGF-21水平的主要因素。结论血清FGF-19、FGF-21水平与胰岛素抵抗、空腹血糖关系密切,可能在GDM的发生发展中起作用。
Objective To investigate the correlation between the levels of fasting serum fibroblast growth factors (FGFs) 19 and 21 and insulin resistance in pregnant women with gestational diabetes mellitus (GDM), and the relationship between the levels of serum FGF-19 and FGF-21 factor. Methods A total of 115 pregnant women were enrolled in the Affiliated Hospital of North China University of Science and Technology from September 2015 to April 2016. According to the oral glucose tolerance test (OGTT) results, they were divided into 55 cases of GDM group and control group 60 cases. The levels of fasting serum FGF-19, fasting blood glucose, fasting insulin, insulin resistance (HOMA-IR) and islet beta cell function (HOMA-β) And other related indicators for analysis. Results The fasting blood glucose, fasting insulin, HOMA-IR and FGF-21 in GDM group were significantly higher than those in control group (P <0.05). The levels of FGF-19 and HOMA-β in GDM group were lower than those in control group (P <0.05). Serum FGF-19 was negatively correlated with pre-pregnancy body mass index, fasting plasma glucose, fasting insulin, HOMA-IR and FGF- 0.05). The serum FGF-21 was positively correlated with pre-pregnancy body mass index, fasting blood glucose, fasting insulin and HOMA-IR (P <0.05), and negatively correlated with HOMA-β and FGF- Regression analysis: fasting blood glucose, HOMA-IR, fasting insulin are the main factors that affect serum FGF-19 level. Fasting blood glucose is the main factor affecting serum FGF-21 level. Conclusion The serum levels of FGF-19 and FGF-21 are closely related to insulin resistance and fasting blood glucose, which may play a role in the development of GDM.