炎症因素及肠道菌群调节对妊娠期糖尿病的影响

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摘要目的探讨炎症因素内毒素、C反应蛋白(CRP)与妊娠期糖尿病(GDM)的关系,并初步了解肠道菌群调节在GDM中的意义。方法选择2018年5月—2020年5月单胎妊娠24～28周的GDM初产妇40例作为研究对象,另设立正常对照组40例,分别进行内毒素、CRP、空腹胰岛素等测定。根据内毒素升高与否将GDM组分为内毒素升高亚组和内毒素正常亚组,根据是否添加益生菌将GDM组分为添加亚组和未添加亚组,血糖控制效果分为A1级(空腹快速血糖<5.3 mmol/L,餐后2 h快速血糖<6.7 mmol/L)和A2级(血糖水平高于A1标准)。结果 GDM组血清内毒素为(0.065±0.027)EU/mL、CRP为(6.40±3.15)mg/L、空腹胰岛素为(16.3±5.2)mU/L,均高于正常对照组(P<0.05)。GDM组功能性便秘发生率为32.5%,早产率22.5%,均高于正常对照组(P<0.05)。GDM组中内毒素升高亚组中空腹胰岛素为(20.2±4.7)mU/L、OGTT空腹血糖为(5.17±0.36)mmol/L、OGTT 1 h血糖为(10.68±0.80)mmol/L、OGTT 2 h血糖为(8.41±0.56)mmol/L,均高于GDM内毒素正常亚组(P<0.05)。GDM孕妇中27例添加益生菌,添加亚组中血糖A1级24例,A2级3例,未添加亚组A1级7例,A2级6例,两组差异有统计学意义(P<0.05)。结论感染因素是胰岛素抵抗、GDM发生发展的重要原因。内毒素来源可能与肠道菌群失调、亚临床感染等有关。调节肠道菌群,合理应用益生菌可能有利于改善胰岛素抵抗及降低GDM 风险。

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	杨娉
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	唐雅兵
	蒋玉蓉

关键词 ：内毒素, C反应蛋白, 妊娠期糖尿病, 口服葡萄糖耐量试验, 胰岛素抵抗, 肠道菌群, 益生菌

收稿日期: 2020-08-10

基金资助:湖南省卫生健康委科研计划课题(B20180713)

通讯作者: 杨娉(30954960@qq.com)

引用本文:

杨娉, 游一平, 唐雅兵, 蒋玉蓉. 炎症因素及肠道菌群调节对妊娠期糖尿病的影响[J]. 中国生育健康杂志, 2021, 32(4): 350-353.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2021/V32/I4/350

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