妊婦における血中プロインスリン分泌動態

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Serum proinsulin is disproportionately elevated both at fasting and after an oral glucose load in non-insulin dependent diabetes mellitus. We investigated the effect of pregnancy on serum proinsulin levels and the proinsulin/insulin ratio (PI/IRI) during an oral glucose tolerance test in pregnant women. Forty-six pregnant women with normal glucose tolerance (NGT), 60 pregnant women with borderline glucose intolerance (BGI), and 10 nonpregnant healthy controls were examined by 75g-oral glucose tolerance test (OGTT). Serum proinsulin was measured by radioimmunoassay using specific antiserum for human proinsulin. Fasting proinsulin levels in nonpregnant controls, NGT in early gestational period, NGT in late gestational, BGI in early gestational, and BGI in lategestational were 5.2 ± 1.2, 6.1 ± 5.9, 8.9 ± 4.5, 8.6 ± 5.5 and 10.9 ± 4.4 pmol/l (mean ± SD), respectively. Fasting PI/IRI ratios in these groups were 0.12 ± 0.04,0.12 ± 0.09,0.19 ± 0.10,0.19 ± 0.13 and 0.27 ± 0.14,respectively.InbothNGTandBGI, fasting proinsulin levels and the PI/IRI ratio in late gestational period were significantly higher than those in the early period. In 27 cases with BGI. OGTT was repeated in the late gestational period. Amelioration of glucose tolerance was observed in 6 cases (group A), but not in 21 cases (group B). Summed values of the serum PI/IRI ratio (2PI/2IRI) during OGTT in early gestationalperiodingroupAwas lowerthaningroup B (0.08 + 0.02 vs 0.15 ± 0.07,p<0.05). The results suggest that serum PI/IRI increases during pregnancy and that serum PI/IRI in early gestational period in BGI case serve as a predictor of glucose tolerance in late gestational period.
1996-10-25

妊婦における血中プロインスリン分泌動態

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