C-反应蛋白、白细胞介素6与妊娠期糖尿病的胰岛素抵抗、血脂相关性研究

目的:探讨妊娠期糖尿病患者血清C-反应蛋(CRP)、白细胞介素6(IL-6)水平变化及其与胰岛素抵抗、血脂的关系。方法:采用放射免疫法测定妊娠24～28周无孕前肥胖的30例妊娠期糖尿病孕妇(GDM组)和30例正常妊娠晚期孕妇(正常妊娠组)的空腹血清IL-6水平,同时测定两组孕妇血清CRP、空腹血糖(FBS)、胰岛素(FINS)、C肽、总胆固醇(TG)和甘油三酯(TC)水平,并计算孕前体重指数(BMI)、胰岛素抵抗指数(HOMA-IRI)以评价胰岛素抵抗程度。结果:两组孕妇空腹血清CRP、IL-6、FBS、F INS、C肽、HOMA-IRI、TG水平及孕前BMI比较,差异有统计学意义(P<0.01或P<0.05),而血清TC水平比较差异无统计学意义(P>0.05);CRP和IL-6的水平分别与HOMA-IRI、TG呈正相关性(r=0.886,0.792,P<0.05;r=0.685,0.767,P<0.05),与TC无相关性(P>0.05)。结论:在无孕前肥胖状况下,妊娠期糖尿病患者血清CRP、IL-6水平的升高与胰岛素抵抗、血脂指标异常有关。

Study on correlation between C-reactive protein,interleukin-6 and insulin resistance,blood lipids in patients with gestational diabetes mellitus

Objective:To explore the changes of serum C-reactive protein(CRP) and interleukin-6(IL-6) levels in patients with gestational diabetes mellitus(GDM) and their relationships with insulin resistance and blood lipids. Methods:Radioimmunoassay(RIA) was used to detect the serum levels of fasting IL-6 in 30 pregnant women with GDM(GDM group) and 30 normal pregnant women during the third trimester of pregnancy(normal pregnancy group);all the pregnant women in the two groups had no pregestational obesity and they were at 24-28 gestational weeks;the levels of serum CRP,fasting blood glucose,insulin,C peptide,total cholesterol,and triglyceride in the two groups were measured during the same time;pregestational body mass index(BMI) and insulin resistance index were calculated to evaluate the degree of insulin resistance. Results:There was statistically significant difference in the levels of fasting CRP,IL-6,fasting blood glucose,insulin,C peptide,insulin resistance index,total cholesterol,and pregestational BMI between the two groups(P<0.01 or P<0.05),but there was no statistically significant difference in the level of serum triglyceride between the two groups(P>0.05).there was a positive correlation between CRP level and insulin resistance index,total cholesterol(γ=0.886,γ=0.792,P<0.05);IL-6 level was positively correlated with insulin resistance index and total cholesterol(γ=0.685,γ=0.767,P<0.05);but there was no correlation between CRP,IL-6 and triglyceride(P>0.05). Conclusion:On the condition of without pregestational obesity,the increases of serum CRP and IL-6 were correlated with insulin resistance and abnormalities of blood lipids indexes in patients with GDM.