区域和宫外肥胖和早孕和晚孕胰岛素敏感性之间的关系
Jonathan Q Purnell1, Nicole Marshall2, Melanie Francisco3
1Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR.
Diabetes care
|February 26, 2026
概括
怀孕早期的胰岛素抵抗与身体脂肪有关,但其他因素在妊娠后期占主导地位. 怀孕前的体重会影响妊娠期间的体重增加,脂肪分布和代谢反应.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 代谢生理学 代谢生理学
- 身体组成分析 身体成分分析
背景情况:
- 胰岛素抵抗是怀孕期间常见的代谢挑战.
- 了解不同脂肪储存在怀孕和胰岛素敏感性中的作用,对于孕产妇和胎儿的健康至关重要.
研究的目的:
- 调查全身,内脏和子宫外脂肪测量与孕妇胰岛素敏感性之间的关联.
- 探索这些关系如何在整个妊娠期间发生变化,并受到怀孕前体重的影响.
主要方法:
- 对不同怀孕前体重的孕妇进行前性研究.
- 身体组成分析包括脂肪质量,内脏脂肪组织 (VAT),肝内脂质 (IHL) 和细胞内脂质 (IMCL).
- 超胰岛素性-高血糖可以评估胰岛素敏感性 (葡萄糖排放率[Rd]),内源性葡萄糖生产 (EGP) 和肝脏胰岛素敏感性指数 (HISI).
主要成果:
- 在怀孕早期,胰岛素敏感性 (Rd) 与体重指数,总脂肪量,皮下脂肪组织 (SAT),VAT,IHL,IMCL和自由脂肪酸 (FFA) 相反相关.
- 肝脏胰岛素敏感度指数 (HISI) 也与几个脂肪指标相反相关,但不是IHL.
- 在怀孕晚期,EGP和Rd与脂肪测量没有相关性,而HISI仍然与BMI,脂肪质量,SAT,VAT和IMCL有关.
结论:
- 怀孕早期的胰岛素抵抗与脂肪,包括子宫外脂肪强烈相关.
- 在怀孕晚期,除了区域和宫外脂肪之外的因素主要影响胰岛素敏感性.
- 怀孕前的体重状况显著改变了怀孕期间的体重增加,脂肪分布和怀孕期间的代谢适应.
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