血清IL-6、hs-CRP与妊娠期糖尿病胰岛素抵抗的关系

目的 探讨妊娠期糖尿病(GDM)患者血清炎症因子IL-6、超敏C反应蛋白(hs-CRP)水平与胰岛素抵抗的关系.方法 在我院产科门诊对孕前无糖尿病和糖耐量异常的24～36周孕妇进行筛查并分组:40例正常孕妇(NGT组)、23例确诊妊娠期糖尿病孕妇(GDM组)、25例孕龄女性(对照组).放射免疫法测IL-6水平,免疫散射比浊法测定hs-CRP水平,同时计算胰岛素抵抗指数HOMA-IT和分泌指数HOMA-B.结果 (1)GDM组血清IL-6、hs-CRP水平均高于NGT组和对照组(P＜0.01),但NGT组和对照组两项指标均无明显差异(P＞0.05).(2)HOMA-IR在GDM组显著高于NGT组和对照组(P＜0.01),NGT组显著高于健康对照组(P＜0.05);HOMA-B在GDM组显著低于NGT组和对照组(P＜0.01),NGT组显著低于对照组(P＜0.01).(3)Pearson相关分析显示FBG、FINS、IL-6、hs-CRP与HOMA-IR显著相关(P＜0.01),多元回归分析提示FINS、FBG、IL-6、hs-CRP是影响HOMA-IR的显著因素(回归系数分别为0.563、0.992、0.325、0.23l,P＜0.01).结论 GDM患者的血清IL-6、hs-CRP水平明显升高,且为影响HOMA-IR的显著因素,提示炎症因子IL-6、CRP可能通过多种机制加重胰岛素抵抗,参与GDM的发病.

Association of serum interleukin-6 and high-sensitivity C-reactive protein levels with insulin resistance in gestational diabetes mellitus

Objective To investigate the association of serum concentration of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) with insulin resistance in women with gestational diabetes mellitus (GDM). Methods Forty normal pregnant women (NGT group) and 23 women with GDM (GDM group) were enrolled in this study with another 25 women of child-bearing age as the control group. Radio immunoassay (RIA) was used to measure the fasting serum IL-6 levels, and immunoturbidimetry performed to evaluate serum hs-CRP levels. The homeostasis model assessment-insulin resistance (HOMA-IR) and the homeostasis model assessment-B (HOMA-B) were calculated. Results Compared with NGT group and control group, GDM group had significantly elevated serum IL-6 and hs-CRP (P<0.01), but the levels were comparable between the former two groups (P>0.05). HOMA-IR was the highest in GDM group (P<0.001), and NGT group had significantly higher HOMA-IR than the control group (P<0.05), whereas the reverse was true for HOMA-B (P<0.01). Pearson correlation analysis showed that fasting blood glucose (FBG), fasting insulin (FINS), IL-6 and hs-CRP had significant association with HOMA-IR (P<0.01). Multiple regression analysis identified FINS, FBG, IL-6, and hs-CRP as the factors significantly affecting HOMA-IR (regression coefficient of 0.563, 0.992, 0.325, and 0.231, respectively, P<0.01). Conclusions Serum levels of IL-6 and hs-CRP are elevated in women with GDM, which are the most significant factors affecting HOMA-IR. IL-6 and CRP may aggravate insulin resistance through various mechanisms and participate in the pathogenesis of GDM.