妊娠糖尿病发病机制与原因探讨

摘要

目的:探讨妊娠糖尿病的发病机制与原因,观察性激素结合球蛋白(SHBG)与妊娠糖尿病的相关性.方法:将2008年1月至2009年12月我院确诊的妊娠糖尿病患者62例作为观察组,随机选取同期未发生妊娠糖尿病患者62例作为对照组,用酶联免疫法(ELISA)测定两组患者静脉血中SHBG、空腹胰岛素(FINS)、空腹血糖(FBG)水平和胰岛素抵抗(IR),比较观察组与对照组上述指标的差异;62例GDM患者经治疗后检测上述指标,比较治疗前后上述指标的变化;查阅相关文献,总结妊娠糖尿病的发病机制与原因.结果:①治疗前观察组SHBG水平为[(1268.56±109.28)nmoL/L],对照组SHBG水平为[(1538.76±112.32)nmoL/L],两组差异具有统计学意义(P<0.05).②治疗后观察组SHBG水平[(1486.54±134.54)nmoL/L],明显提高,与治疗前观察组SHBG水平差异具有统计学意义(P<0.05),与对照组SHBG水平无统计学意义(P>0.05).③治疗前后空腹胰岛素(FINS)、空腹血糖(FBG)水平和胰岛素抵抗(IR)变化差异无统计学意义(P>0.05).结论:妊娠糖尿病发病机制涉及遗传因素、胰岛素抵抗、分娩缺陷、慢性炎症反应、代谢紊乱等因素;孕早期低水平血清SHBG是妊娠糖尿病的独立危险因素,可能与糖尿病致病原因相关.%Objective: To study the pathogenesis and causes of gestational diabetes mellitus, and to observe the correlation between SHBG and gestational diabetes. Method: 62 cases with gestational diabetes who were treated in our hospital from January 2008 to December 2009 were chosen as the observation group,62 patients without gestational diabetes in the same period were chosen as the control group. The SHBG,FINS, FBG,IR level of all patients were tested by using ELISA, the difference between two groups were compared. Their levels were tested in 62 cases of GDM patients after treatment, the changes before and after treatment were compared. Then reviewed literatures and summarized the pathogenesis and causes of GDM.Result: Before treatment, the levels of SHBG in the observation group was ( 1268.56 + 109.28) nmol / L,the levels of SHBG in the control group was ( 1538.76 ± 112.32) nmol / L, The difference was statistically significant ( P ＜0.05 ). ②After treatment, the levels of SHBG in the observation group was ( 1486.54 +134.54) nmol/L, it was markedly improved and significantly higher than that of before( P ＜0.05 ), but there were no significant difference compared with the control groups ( P＞ 0. 05 ). ③There was no significant changes of the SHBG, FINS, FBG, IR levels before and after treatment ( P＞ 0. 05 ). Conclusion: The pathogenesis of GDM includes genetic factors, insulin resistance, birth defects, chronic inflammation, metabolic disorders and other factors, Low serum SHBG in early pregnancy is an independent risk factor of GDM, it maybe associated with the pathogenesis of GDM.