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Insulin resistance

内分泌

关键词内分泌 临床研究术语 糖尿病

词汇介绍

拓展阅读

解析

Insulin   英 /'ɪnsjʊlɪn/   美 /'ɪnsəlɪn/

       n. [生化][药] 胰岛素

       Check your blood sugar level before and after any activity, especially if you take insulin. 在运动前和后检查你的血糖水平,尤其是,如果你服用了胰岛素。

 

Resistance   英/rɪ'zɪst(ə)ns/   美 /rɪ'zɪstəns/

       n. 阻力;电阻;抵抗;反抗;抵抗力

同根词   adj. resistant 抵抗的,反抗的;顽固的;

               n. resist [助剂] 抗蚀剂;防染剂;

               vi. resist 抵抗,抗拒;忍耐;

               vt. resist 抵抗;忍耐,忍住。

       They broke down all resistance. 他们镇压了一切抵抗。

概述

胰岛素抵抗(Insulin resistance,IR)是一种胰岛素效应减低的现象,胰岛素作用的靶器官对胰岛素作用的敏感性下降,即正常剂量的胰岛素产生低于正常生物学效应的一种状态。IR不仅是2型糖尿病的发病基础,更是多种代谢相关疾病的共同病理生理基础。诊断①空腹血糖浓度;②高胰岛素-正葡萄糖钳夹;③胰岛素敏感性试验;④联合葡萄糖胰岛素耐量试验;⑤快速静脉葡萄糖耐量试验。预防和管理保持健康的体重和身体活动可以帮助降低发生胰岛素抵抗的风险。胰岛素抵抗的主要治疗方法是运动和减肥。二甲双胍和噻唑烷二

Characteristics and pregnancy outcomes across gestational diabetes mellitus subtypes based on insulin resistance复制标题

基于胰岛素抵抗的妊娠期糖尿病亚型特征及妊娠结局

发表时间:2019-07-23

影响因子:7.1

作者: Katrien Benhalima

期刊:Diabetologia

Previous small studies have suggested that GDM is a heterogeneous disease, mostly related to differences in BMI. The North American study of Powe et al in a predominantly white population suggested a greater risk of adverse pregnancy outcomes in women with GDM with impaired insulin sensitivity. In that study, women with impaired insulin sensitivity had a significantly higher rate of Caesarean sections and larger infants compared with women with NGT, which persisted after adjustment for BMI. This is in contrast to our results, since we found that women with high insulin resistance had similar rates of LGA infants and fetal macrosomia but significantly higher rates of preterm delivery, labour inductions, Caesarean sections, neonatal hypoglycaemia and NICU admissions compared with women with NGT. The total number of Caesarean sections in the high insulin resistance group vs the NGT group was relatively similar between the Powe et al study (33.3% vs 15.2%) and our data (28.7% vs 19.4%). In contrast, the rates of LGA infants (11.7%) and neonatal hypoglycaemia (15.4%) in the high insulin resistance group were lower in our study than in the Powe et al study (26.5% and 23.5%, respectively). In addition, after adjustment for several variables such as BMI, FPG and lipid levels in early pregnancy, the risks of preterm delivery and neonatal hypoglycaemia remained significantly higher in the high insulin resistance group compared with the NGT group in our study. Our data suggest, therefore, that the increased risk of adverse outcomes in women with GDM with high insulin resistance cannot be entirely explained by a higher BMI, FPG and fasting lipid levels in early pregnancy. At this point, we can only speculate on possible additional mechanisms of the increased risk of adverse complications in women with GDM with impaired insulin sensitivity. Previous studies have identified biomarkers involved in specific metabolite groups and several pathways in women with GDM, including amino acid metabolism, steroid hormone biosynthesis, glycerophospholipid metabolism and fatty acid metabolism. Further research is warranted to determine if metabolomics will result in new indicators for the management of GDM and GDM-related complications. Differences in outcomes between GDM subtypes might also be related to differences in (epi)genetic susceptibility. Differences between our study and that of Powe et al may be related to population differences, since our sample size was much larger and had a higher prevalence of GDM and of women from an ethnic minority background. In addition, we had more clinical and biochemical variables available in early and later pregnancy for adjustment of outcomes.

译文

以前的小型研究表明,GDM是一种异质性疾病,主要与BMI的差异有关。北美对Powe等人的白人群体的研究表明,对于胰岛素敏感性受损的GDM女性,不良妊娠结局的风险更大。在该研究中,胰岛素敏感性受损的女性剖腹产和婴儿的比例显着高于NGT女性,这些女性在调整BMI后持续存在。这与我们的结果形成对比,因为我们发现具有高胰岛素抵抗的女性具有相似的LGA婴儿和巨大胎儿的发生率,但是与NGT女性相比,早产,分娩,剖腹产,新生儿低血糖和新生儿重症监护病房入院的发生率显着更高。 。高胰岛素抵抗组与NGT组的剖腹产总数在Powe等研究(33.3%对15.2%)和我们的数据(28.7%对19.4%)之间相对相似。相反,在我们的研究中,高胰岛素抵抗组的LGA婴儿(11.7%)和新生儿低血糖(15.4%)的发生率低于Powe等人的研究(分别为26.5%和23.5%)。此外,在调整了妊娠早期的BMI,FPG和脂质水平等几个变量后,与我们研究中的NGT组相比,高胰岛素抵抗组的早产和新生儿低血糖的风险仍然显着更高。因此,我们的数据表明,妊娠早期BMI,FPG和空腹血脂水平升高不能完全解释患有高胰岛素抵抗的GDM女性不良后果的风险增加。在这一点上,我们只能推测胰岛素敏感性受损的GDM女性不良并发症风险增加的可能的其他机制。以前的研究已经确定了涉及特定代谢物组的生物标志物和GDM女性的几种途径,包括氨基酸代谢,类固醇激素生物合成,甘油磷脂代谢和脂肪酸代谢。需要进一步的研究来确定代谢组学是否会为GDM和GDM相关并发症的管理带来新的指标。 GDM亚型之间结果的差异也可能与(epi)遗传易感性的差异有关。我们的研究与Powe等人的研究之间的差异可能与人口差异有关,因为我们的样本规模要大得多,并且GDM和少数民族背景的女性患病率较高。此外,我们在妊娠早期和晚期有更多的临床和生化变量可用于调整结果。