妊娠期糖尿病母亲婴儿脐血C肽和胰岛素水平与胰岛素抵抗的关系

目的了解妊娠期糖尿病母亲婴儿的脐血C肽和胰岛素水平与胰岛素抵抗的相关性。方法取足月单胎妊娠期糖尿病母亲婴儿48例为研究组，选择同期正常母亲婴儿48例为对照组，分别对两组产妇分娩时抽取脐带血检测血糖、C肽及胰岛素水平，同时测量婴儿的体重，身长，计算婴儿重量指数（PI）及稳态模型胰岛素抵抗指数（HOMA-IR），采用Pearson线性相关法分析婴儿脐血C肽及胰岛素水平及重量指数与HOMA-IR指数的相关性。结果妊娠期糖尿病母亲婴儿重量指数[（2．86±0．18）g／cm3]高于对照组[（2．61±0．17）g／cm3，P〈0．01]，脐血的C肽[（1．91±0．98）μg/L]、胰岛素水平[（24．87±5．82）mu／L]及HOMA—IR（3．14±0．96）均高于对照组[（1．28±0．45）μg/L、（12．48±2．41）μg／L、（2．02±0．78），P〈0．05或P〈0．01]，而血糖水平[（2．78±0．26）mmol/L]低于对照组[（3．54±0．47）mmo/L，P〈0．05]，婴儿脐血的c肽和胰岛素水平、重量指数与HOMA—IR呈正相关（r=0．42，0．36，P〈0．01；r=0．29，P〈0．05）。结论HOMA—IR与妊娠期糖尿病母亲婴儿脐血C肽、胰岛素水平及重量指数增加密切相关，监测婴儿脐带血C肽和胰岛素水平可早期发现婴儿的异常代谢，及时采取干预措施减少儿童肥胖症，延缓成年后2型糖尿病等代谢性疾病的发生发展。

The relationship between insulin resistance and umbilical cord blood C peptide and insulin of infants of gestational diabetes mothers

Objective To explore the relationship between insulin resistance and umbilical cord blood C peptide and insulin of infants of diabetic mothers. Methods Single full-term infants of diabetic mothers 48 cases were selected for study group, and normal mother neonatal 48 cases for control group. Cord blood was extracted during neonatal delivering. The blood glucose, C peptide, and insulin were tested. The baby＇s weight and body length were measured. The neonatal ponderal index（PI） and homeostasis model assessment of insulin resistance （HOMA-IR） were calculated. The relationship between HOMA-IR and umbilical cord blood C peptide, insulin of infants and ponderal index were analyzed with Pearson correlation method. Results The ponderal index of infants of diabetic mothers[ （2. 86±0. 18）g/cm3 ] was significantly higher than that of control group [ （2. 61 ± 0. 17 ） g/cm3, P 〈 0. 01 ]. The cord blood C peptide （1.91 20. 98） μg/L, insulin （24. 87 ±5. 82）mu/L, and HOMA-IR （3.14 20. 96） of infants of diabetic mothers were significantly higher than those of control group [ （ 1.28 ± 0.45 ） μg/L, （ 12.48 ± 2.41 ） μg/L, （2. 02 20. 78）, P 〈0. 05 orP 〈0. 01 ]. The blood glucose（2. 78 ±0. 26）mmol/L was significantly lower than that of control group [ （3.54 ± 0. 47） retool/L, P 〈 0. 05 ]. All of the babies cord blood C peptide, insulin and weight index were positively correlated with HOMA-1R （ r = 0. 42, 0. 36, P 〈 0. 01 ; r = 0. 29, P 〈 0. 05 ）. Conclusions Infants of diabetic mothers cord blood C peptide, insulin, and ponderal index were closely associated with HOMA-IR. Monitoring the C peptide and insulin may early detect their abnor- mal metabolism for timely intervention measures to reduce childhood obesity and delay the adult metabolic diseases such as type 2 diabetes development.