Alternative Title妊娠糖尿病女性における産後１年後の耐糖能異常発症には、インスリンおよびグルカゴンの分泌障害が関与する（産褥期の75gOGTT検査を使用した前向きコホート研究）
Degree grantor/typeNagasaki University (長崎大学)
Note (General)Gestational diabetes mellitus (GDM) is known to be a significant risk factor for the future development of type 2 diabetes. Here, we investigated whether a precise evaluation of β- and α-cell functions helps to identify women at high risk of developing glucose intolerance after GDM. Fifty-six women with GDM underwent a 75-g oral glucose tolerance test (OGTT) at early (6–12 weeks) postpartum. We measured their concentrations of glucose, insulin, proinsulin and glucagon at fasting and 30, 60 and 120 min. At 1-year post-delivery, we classified the women into a normal glucose tolerance (NGT) group or an impaired glucose tolerance (IGT)/diabetes mellitus (DM) group. Forty-three of the 56 women completed the study. At 1-year post-delivery, 17 women had developed IGT/DM and 26 women showed NGT. In the early-postpartum OGTTs, the IGT/DM group showed a lower insulinogenic index, a less glucagon suppression evaluated by the change from fasting to 30 min (ΔGlucagon 30 min), and a higher glucagon-to-insulin ratio at 30 min compared to the NGT group. There were no significant between-group differences in proinsulin levels or proinsulin-to-insulin ratios. Insulinogenic index <0.6 and ΔGlucagon 30 min >0 pg/mL were identified as predictors for the development of IGT/DM after GDM, independent of age, body mass index, and lactation intensity. These results suggest that the bihormonal disorder of insulin and glucagon causes the postpartum development of glucose intolerance. The measurement of plasma insulin and glucagon during the initial OGTT at early postpartum period can help to make optimal decisions regarding the postpartum management of women with GDM.
長崎大学学位論文 学位記番号:共博(医歯薬)甲第20号 学位授与年月日:令和4年3月18日
Author: Riyoko Shigeno, Ichiro Horie, Masaki Miwa, Ayako Ito, Ai Haraguchi, Shoko Natsuda, Satoru Akazawa, Ai Nagata, Yuri Hasegawa, Shoko Miura, Kiyonori Miura, Atsushi Kawakami, Norio Abiru
Citation: Endocrine Journal, 68(8), pp. 919-931; 2021
identifier:Nagasaki University (長崎大学), 博士(医学) (2022-03-18)
http://hdl.handle.net/10069/00041164
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2022-06-05T18:01:14+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション