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目的：探讨血清性激素结合球蛋白（SHBG）水平与妊娠期糖尿病（GDM）胰岛素抵抗（IR）的关系。方法：选择2015 年3 月 ~2016年1 月在我院收治的90 例GDM孕妇为观察组，选择同期健康体检孕妇45例为对照组，采用化学发光法检测两组孕妇的 SHBG、胰岛素(INS)、C 肽和游离睾酮（FT），糖化血红蛋白仪检测糖化血红蛋白（HbA1c），生化分析仪检测空腹血糖（FBG），并计算胰岛素抵抗指数（HOMA-IR）和敏感性指数（ISI），分析两组孕妇各指标的关系及其与两指数的相关性。结果：观察组孕妇空腹及餐后2h、3h 的INS 水平高于对照组，差异有统计学意义（P<0.05）。观察组孕妇餐后1h 和2h 的C 肽水平低于对照组，而餐后3h 高于对照组，差异有统计学意义（P<0.05）。观察组孕妇SHBG 水平、ISI低于对照组，而HOMA-IR、FT 、FBG和HbA1c 水平高于对照组，差异有统计学意义（P<0.05）。SHBG 水平与FINS、C 肽水平、HOMA-IR 呈负相关，与ISI 呈正相关，差异有统计学意义（P<0.05）。结论：GDM孕妇胰岛素抵抗性和敏感性下降，血清SHBG 水平降低且与INS 水平、IR 及敏感性相关，检测血清SHBG 水平有助于了解GDM孕妇IR 情况。

英文摘要:

Objective:To study the relationship between sex hormone-binding globulin (SHBG) and insulin resistance in pregnant woman with gestational diabetes mellitus (GDM).Methods:90 pregnant woman with gestational diabetes who were treated in our hospital from March 2015 to January 2016 were selected as the observation group, and 45 cases of healthy pregnant women were selected as the control group. The content of SHBG, insulin (INS), C peptide and free testosterone (FT) of two groups were detected by chemiluminescence method. Glycosylated glycosylated hemoglobin (HbA1c) was tested by hemoglobin meter testing, and the fasting blood glucose (FBG) were rested by biochemical analyzer. The insulin resistance (HOMA-IR) and sensitivity index (ISI) were calculated. The relationship of the indexes between two groups and the relationship between the indexes and the two exponents were analyzed.Results:The insulin levels of limosis and postprandial 2 h and 3 h in observation group were higher than the control group, the difference was statistically significant (P<0.05). The C peptide value of the observation group in 1 h and 2 h after meal were lower than the control group, while the C peptide value in 3 h after meal was higher than the control group, the differences were statistically significant (P<0. 05). The levels of SHBG and ISI in observation group were lower than the control group, and the HOMA-IR, FT, FBG and HbA1c in observation group were higher than the control group, the differences were statistically significant (P<0.05). SHBG were negative correlated to FINS, C peptide, HOMA-IR, and which was positively correlated to ISI, the differences were statistically significant (P<0. 05).Conclusion:The pregnant woman with GDM decreases with insulin resistance and sensitivity insulin, Serum SHBG levels are decreased and correlated with INS levels, IR and sensitivity. Detecting the serum level of SHBG can help to know the insulin resistance of GMD.

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