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醛固酮与妊娠糖尿病的相关性研究

李利平   

  1. 河南科技大学第一附属医院内分泌科
  • 收稿日期:2014-01-09 修回日期:2014-06-19 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 李利平

Correlation Between Aldosterone and Gestational Diabetes Mellitus

LI LI ping   

  1. Department of Endocrinology, The First Affiliated Hospital of Henan Technology University
  • Received:2014-01-09 Revised:2014-06-19 Published:2014-11-15 Online:2014-11-15
  • Contact: LI LI ping

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摘要：

【摘要】 目的 探讨妊娠时醛固酮变化与妊娠糖尿病（GDM）的关系。 方法 依试验结果随机筛选出妊娠糖尿病（GDM）组、妊娠糖耐量正常（NGT）组和对照组， 各 20 例。 计算孕前体质量指数（BMI）； 糖耐量试验时同时检测空腹血糖(FBG)、血脂、空腹胰岛素(Fins)、计算 HOMA-IR 指数， 测定立位肾素-血管紧张素-醛固酮（RASS）， 记录肾素活性（PRA）、血管紧张素Ⅱ（ATⅡ）、醛固酮（ALD）。 结果 GDM 组醛固酮水平明显高于 NGT 组和对照组（pmol/L：1 130.15±135.45 vs 1 053.98±108.86 vs 544.31±127.97）， 醛固酮与 FBG、1 hPBG、2 hPBG、Fins、HOMA-IR、TG 呈正相关(r 分别为 0.658、0.701、0.652、0.757、0.713、0.429， P＜ 0.05)， 与 HDL-C 呈负相关(r=-0.267,P=0.039)。 多元逐步回归分析提示醛固酮为 GDM 的危险因素。 结论 妊娠时 RASS 系统的过度激活与 GDM 的发生有关。

关键词: 糖尿病, 妊娠, 醛固酮, 回归分析, 胰岛素抵抗

Abstract:

[Abstract]   Objective   To analyze the relationship between plasma aldosterone level and gestational diabetes melli?
tus.   Methods   All subjects were divided into three groups (n=20 in each group): gestational diabetes mellitus (GDM) group，pregnancy with normal glucose group， non-pregnant healthy women group. Pre-pregnant body mass index (BMI) was calculated, and fasting blood glucose (FBG), blood lipid level, Fins, HOMA-IR index, RASS, PRA, ATIi and ALD were examined besides glucose intolerance test.   Results   The plasma ALD level was significantly higher in GDM group than that of NGT group and control group（pmol/L： 1 130.15±135.45 vs 1 053.98±108.86 vs 544.31±127.97）. The plasma ALD level was positively correlated with FBG,1 h PBG ,2 hPBG， Fins , HOMA-IR and blood triglyceride (r=0.657, 0.757, 0.713, 0.429， P＜0.05)， but negatively correlated with HDL-C（r=-0.267， P=0.039）. Stepwise regression analysis revealed that plasma aldosterone was the independent risk factor of GDM.   Conclusion   RASS is excessively activated in pregnancy, which contributes to gestational diabetes mellitus.

Key words: diabetes, gestational, aldosterone, regression analysis, Insulin Resistence