目的：探讨妊娠期糖尿病（GDM）巨大儿胰岛素样生长因子1（IGF-1）、IGF-2与糖脂代谢的关系。方法选取2012年1月至2015年1月榆林市第二医院产科住院并确诊为妊娠期糖尿病的孕妇所分娩的体质量＞4000 g婴儿50例作为GDM巨大儿组，健康孕妇分娩的健康足月巨大儿50例作为健康巨大儿组，健康孕妇分娩的正常体质量的足月新生儿50例作为正常对照组，检测并比较IGF-1、IGF-2、血糖及血脂水平。结果 GDM巨大儿组新生儿 IGF-1、IGF-2高于健康巨大儿组和正常对照组新生儿[（1.28±0.43）μg／L比（0.96±0.32）μg／L，（0.89±0.21）μg／L；（1.14±0.34）μg／L比（0.93±0.27）μg／L，（0.85±0.21）μg／L，P＜0.01]。 GDM巨大儿组新生儿空腹血糖、高密度脂蛋白胆固醇、apoA及apoB低于健康巨大儿组和正常对照组新生儿[（2.17±0.31） mmol／L比（2.61±0.40） mmol／L，（2.77±0.63） mmol／L；（1.32±0.15） mmol／L 比（1.37±0.15） mmol／L，（1.39±0.11） mmol／L；（0.56±0.15） g／L比（0.66±0.22） g／L，（0.79±0.27） g／L；（0.36±0.11） g／L 比（0.51±0.17） g／L，（0.63±0.21） g／L]（P＜0.01）；DM 巨大儿组新生儿三酰甘油高于健康巨大儿组和正常对照组新生儿[（0.61±0.16） mmol／L 比（0.52±0.14） mmol／L，（0.49±0.14） mmol／L]（ P＜0.01）；健康巨大儿组新生儿 apoA 及 apoB 两项指标均低于正常对照组新生儿（ P ＜0.05）。GDM巨大儿组IGF-1与新生儿体质量、三酰甘油呈正相关（r＝0.66，0.68，P＜0.05），与空腹血糖呈负相关（r＝－0.58，P＜0.05）。 GDM巨大儿组 IGF-2与体质量、三酰甘油呈正相关（r＝0.52，0.57， P＜0.05），与空腹血糖呈负相关（r＝－0.57，P＜0.05）。结论 GDM 患者胎盘内 IGF-1、IGF-2水平升高，并存在血糖、血脂代谢紊乱，IGF-1、IGF-2水平与 GDM 巨大儿体质量、空腹血糖及三酰甘油间存在密切关系。%Objective To investigate the relationship between insulin-like growth factor(IGF)-1, IGF-2 and macrosomia glucose and lipid metabolism associated with gestational diabetes mellitus(GDM).Methods Total of 50 GDM patients whose infants were >4000 g in Yulin Second Hospital from Jan.2012 to Jan. 2015 were included as a GDM macrosomia group,another 50 healthy pregnant women with healthy giant infants were included as a healthy macrosomia group,and 50 healthy pregnant women with healthy normal weight infants were included as a healthy control group.The levels of IGF-1,IGF-2,blood glucose and lipid of the two groups were detected and compared.Results IGF-1, IGF-2 of the GDM macrosomia group new-borns were all higher than the healthy macrosomia group and healthy control group[(1.28 ±0.43) μg/L vs (0.96 ±0.32) μg/L,(0.89 ±0.21) μg/L;(1.14 ±0.34) μg/L vs (0.93 ±0.27) μg/L,(0.85 ± 0.21) μg/L,P<0.01].Fasting glucose,high density lipoprotein choleseterol,apo A,apo B of GDM macro-somia group newborn were all significantly lower than the healthy macrosomia group and healthy control group [(2.17 ±0.31) mmol/L vs (2.61 ±0.40) mmol/L,(2.77 ±0.63) mmol/L;(1.32 ±0.15) mmol/L vs (1.37 ±0.15) mmol/L,(1.39 ±0.11) mmol/L;(0.56 ±0.15) g/L vs (0.66 ±0.22) g/L,(0.79 ± 0.27) g/L;(0.36 ±0.11) g/L vs (0.51 ±0.17) g/L,(0.63 ±0.21) g/L](P<0.01).Triglyceride of the GDM macrosomia group newborn was significantly higher than the healthy macrosomia group and healthy control group[(0.61 ±0.16) mmol/L vs (0.52 ±0.14) mmol/L,(0.49 ±0.14) mmol/L](P<0.01). ApoA and apoB in the healthy macrosomia group newborn were lower than the control group(P<0.01).In the GDM macrosomia group, IGF-1 was positively correlated with newborn body weight, triglyceride ( r =0.66, 0.68, P<0.05),and negatively correlated with blood glucose(r =-0.58,P <0.05);IGF-2 was positively correlated with body weight,triglyceride (r=0.52,0.57,P<0.05),and was negatively correlated with blood glucose(r=-0.57,P <0.05).Conclusion The levels of IGF-1 and IGF-2 in placenta of patients with GDM are elevated,and blood glucose and lipid metabolisms disorders are observed,and IGF-1, IGF-2 levels are closely associated with the body mass,blood glucose and triglyceride in GDM macrosomia.
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