妊娠糖尿病患者超敏C反应蛋白动态变化与胰岛素抵抗的关系

Alteration of serum high-sensitivity C-reactive protein level in gestational diabetes mellitus and correlation with in insulin resistance

  • 摘要: 目的 探讨妊娠糖尿病患者超敏C反应蛋白(hs-CRP)动态变化与胰岛素抵抗(IR)的关系。方法 选择妊娠糖尿病(GDM)患者32例和正常糖耐量(NGT)孕妇3l例为研究对象,分别测定孕25~28周、孕29~32周、孕37~38周、产后6~8周空腹血清hs-CRP、空腹胰岛素(FINS)、空腹血糖(FBG)水平,采用放射免疫法测定FINS,葡萄糖氧化酶法测定FBG,免疫散射比浊法测定hs-CRP,以HOMA胰岛索抵抗指数(HOMA-IR)评价IR。结果 (1) GDM组和NGT组血清hs-CRP水平在妊娠各阶段(孕25~28周、孕29~32周、孕37~38周)的变化不明显,但均显著高于产后;(2) GDM组妊娠各阶段血清hs-CRP水平均高于NGT组(t值分别为7.31、7.78、6.33,P<0.01);(3) GDM组妊娠各阶段HOMA-IR均显著高于NGT组(t值分别为31.18、31.10、28.39,P<0.01);(4) Pearson相关分析显示。FBG、FINS、hs-CRP与HOMA-IR显著相关(相关系数分别为0.478、0.902、0.293,P<0.01),多元回归分析提示,FINS、FBG、hs-CRP是影响HOMA-IR的显著因素(回归系数分别为0.441、0.876、0.261,P<0.01)。结论 GDM患者血清hs-CRP水平在妊娠的不问阶段变化不明显,但显著高于NGT组,且与HOMA-IR显著相关。

     

    Abstract: Objective To explore the dynamic of high-sensitivity C-reactive protein (hs-CRP) and its correlation with insulin resistance (IR) during different stages of gestational diabetes mellitus (GDM). Methods Thirty-two subjects with GDM and thirty-one cases of normal glucose tolerance (NGT) pregnant women were enrolled in the study,fasting insulin (FINS) were determined by radioimmunoassay,the fasting blood glucose (FBG) was measured by using glucose oxidase,immunoturbidimetry performed to evaluate serum hs-CRP levels.Tests repeated for each group according different stages of prenatal 25-28 weeks,29-32 weeks,37-38 weeks and postpartum 6-8 weeks.IR was assessed by the homeostasis model assessment insulin resistance index (HOMA-IR),Results ①Serum hs-CRP levels in NGT and GDM had few change with gestational age,but both significantly decreased at postpartum.②Serum hs-CRP levels in GDM significantly increased than NGT in the same stage (t was 7.31,7.78,6.33,respectively,P<0.01).③HOMA-IR in GDM significantly increased than NGT in the same gestational stage (t was 31.18,31.10, 28.39,respectively,P<0.01).④Pearson correlation analysis showed that FBG,FINS and hs-CRP had significant association with HOMA-IR (regression coefficient of 0.478,0.902,0.293,respectively,P<0.01). Multiple regression analysis identified FINS,FBG and hs-CRP as the factors significantly affecting HOMA-IR (regression coefficient of 0.441,0.876,0.261,respectively,P<0.01).Conclusion Serum hs-CRP levels in GDM had few change with gestational age,but all significantly increased than NGT in the same stage,and which were the most significant factors affecting HOMA-IR.

     

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