妊娠糖尿病中肌肉/脂肪质量比与胰岛素抵抗的关系

摘要 目的：探究妊娠糖尿病中肌肉/脂肪质量比与胰岛素抵抗的相关性。方法：选择2015年1月至2020年1月于我院接受治疗的300例产妇为研究对象，按照美国糖尿病学会（American Diabetes Association，ADA）标准将产妇区分为妊娠期糖尿病组（GDM=90例）、妊娠期糖耐量受损组（GIGT=110例）和糖耐量正常组（NGT=100例），分别检测三组产妇的总胆固醇（total cholesterol，TC）、三酰甘油（Triglycerides，TG）、糖化血红蛋白（glycosylated hemoglobin，HbAlc）、肌肉/脂肪质量比（muscle / fat mass ratio，M/F）以及空腹血清胰岛素（fasting insulin，FINS）水平。结果：（1）GDM组患者HbAlc、TC以及TG水平均明显高于GIGT组以及NGT组（P<0.05），GIGT组患者HbAlc、TC以及TG水平均明显高于NGT组（P<0.05）；（2）GMD组产妇的M/F明显低于GIGT组产妇，GIGT组产妇明显低于NGT组产妇（P<0.05），而GMD组产妇FINS以及胰岛素抵抗（insulin resistance，IR）明显高于GIGT组，GIGT组明显高于NGT组（P<0.05）；（3）胰岛素抵抗（IR）同M/F呈现负相关联系（r=-0.218，P<0.05），同时与HbAlc、TC、TG（r=0.346，r=0.412，r=0.372，P<0.05）等呈现正相关。结论：妊娠女性的M/F值不足同胰岛素抵抗的出现具有一定的相关性，过分强调产妇节食可能会使产妇出现较低的肌肉质量，从而增加GDM的发生风险。

Relationship between Muscle / Fat Mass Ratio and Insulin Resistance in Gestational Diabetes

ABSTRACT Objective: To explore the relationship between muscle/fat mass ratio and insulin resistance in gestational diabetes mellitus. Methods: 300 pregnant women who were treated in our hospital from January 2015 to January 2020 were divided into gestational diabetes group (GDM=90 cases), gestational impaired glucose tolerance group(GIGT=110 cases) and normal glucose tolerance group(NGT=100 cases) according to the standards of American Diabetes Association(ADA). The total cholesterol (TC), triglyceride(TG), glycosylated blood red of the three groups were detected respectively Protein (HbAlc), muscle / fat mass ratio (M/F) and fasting serum insulin (fins) levels. Results: (1) The levels of HbAlc, TC and TG in GDM group were significantly higher than those in GIGT group and NGT group(P<0.05). The levels of HbAlc, TC and TG in GIGT group were significantly higher than those in NGT group(P<0.05). (2) The M/F of GMD group was significantly lower than that of GIGT group, and that of GIGT group was significantly lower than that of NGT group(P<0.05). In GMD group, fins and IR were significantly higher than those in GIGT group, GIGT group was significantly higher than NGT group(P<0.05). (3) IR was negatively correlated with M/F(r=- 0.218, P<0.05), at the same time, it was positively correlated with HbAlc, TC, TG(r=0.346, r=0.412, r=0.372, P<0.05). Conclusion: The insufficient M/F value of pregnant women was related to the occurrence of insulin resistance. Overemphasis on maternal diet may lead to lower muscle mass and increase the risk of GDM.