妊娠性糖尿病患者超敏C反应蛋白水平变化及意义

目的探讨超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平在妊娠性糖尿病(gestational diabetes mellitus,GDM)患者体内水平变化及其与血糖变化的关系。方法 ELISA法检测GDM 20例,糖尿病患者19例血清hs-CRP、白高效液相法检测糖化血红蛋白(glycosylated hemoglobin A-1,GHbA-1)、生化法检测血糖水平,并与健康对照组(16例)比较,同时对hs-CRP与血糖、GHbA-1变化及GDM患者孕龄间进行相关关系分析。结果妊娠糖尿病组、糖尿病组与健康对照组间hs-CRP、血糖、GHbA-1水平差异均有统计学意义(f值分别为:12.041、26.356、13.561;P<0.001)。GDM患者及糖尿病组hs-CRP水平高于健康对照组,hs-CRP水平在GDM患者及糖尿病组无明显差别。糖尿病组hs-CRP与血糖、GHbA-1平均呈正相关(r=0.866,0.475;P=0.001,0.04),GHbA-1与血糖呈正相关(r=0.471,P=0.042)。妊娠糖尿病组:GHbA-1与血糖水平均呈正相关(r=0.528,P=0.020),妊娠糖尿病患者hs-CRP水平与孕龄两者间无相关(r=0.065,P=0.792)。健康对照组内各指标间无相关。结论 GDM及糖尿病患者血糖及GHbA-1水平可致患者hs-CRP高表达。高水平hs-CRP可能诱发胰岛素抵抗,并对妊娠结果存在影响。

Change of serum hs-CRP in gestational diabetes mellitus and its clinical significance

Objective To investigate the change of serum concentration of high-sensitivity C-reactive protein（hs-CRP） in gestational diabetes mellitus （GDM） and its relation with the change of blood glucose. Methods 20 cases of GDM, 19 cases of diabetic mrllitus （DM） and 16 cases of health persons were detected the levels of serum hs-CRP by ElJSA,glycosylated hemoglobin A-1 （GHbA-1 ） by the high performance liquid chromatography （HPLC） and blood glucose by the biochemial method. The relation between the change of hs-CRP and GHbA-1 with the gestational age of GDM was analyzed. Results The serum con- centrations of hs-CRP, GHbA-1 and blood glucose had significant differences among three groups 0c= 12.041,13.561,26.356 ;all P〈 0.001 ） and the serum oncentrations of hs-CRP in the GDM and DM groups was higher than that in the health control group （P〈0.01） ,but the hs-CRP level had no significant difference between the GDM and DM groups. The positive correlation was found between hs-CRP and blood glucose and GHbA-1 in the DM group （r=0.866,0.475 ;P=0.001,0.04） ,so did GHbA-1 and blood glucose （r=-0.471 ,P=-0.042. In the GDM group, GHbA-1 was positively correlated with blood glucose （r=0.528,P=0.020）, but no relation existed between hs-CRP and pregnant weeks （r=0.065 ,P=0.792）. No corelation was found among the various indexes in the normal control group. Conclusion Blood glucose and GHbA-1 levels in the patients with GDM and DM cause high expression of hs-CRP. High hs-CRP could induce insulin resistance and affect the pregnant results