孕妇妊娠中晚期C-反应蛋白与胰岛素抵抗及血脂的相关性研究

Study on the relationship between C-reactive protein and insulin resistance,blood lipid in pregnant women with varying glucose tolerances

目的:探讨不同糖代谢水平孕妇妊娠中晚期血清C-反应蛋白(CRP)水平变化及其与胰岛素抵抗(IR)、血脂的关系。方法:82例孕妇分为妊娠期糖尿病组(GDM组)28例、妊娠期糖耐量异常孕妇组(GIGT组)25例、糖耐量正常孕妇组(NGT组)29例。分别于妊娠中晚期测定孕妇血清CRP、空腹血糖(FBS)、胰岛素(FINS)、总胆固醇(TG)、甘油三酯(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平,并计算各期胰岛素抵抗指数(HOMA-IRI)。结果:(1)82例孕妇妊娠晚期CRP水平较中期有升高,但无统计学意义(P>0.05);妊娠中期CRP水平与HOMA-IRI及TG密切相关(r=0.408,P<0.01;r=0.257,P<0.05);(2)GDM组孕妇妊娠中期血清CRP、HOMA-IRI均明显高于GIGT组及NGT组(P<0.05);(3)3组孕妇妊娠中期CRP水平均与HOMA-IRI及TG密切相关。结论:孕妇妊娠中期血清CRP水平与糖、脂代谢水平有关,尤其是在GDM患者中,妊娠中期CRP水平可作为有效的发病预测指标之一。

Objective To investigate the serum concentration of C-reactive protein（CRP） and the correlation with insulin resistance, blood lipid in pregnant women with varying glucose tolerances. Methods All of 82 pregnant women were allocated into this study, including gestational diabetes mellitus（GDM） women（ n = 28 ）, gestational impaired glucose tolerance（GIGT） women（ n = 25 ） and normal glucose tolerance （NGT） women （ n = 29 ）. The blood samples were collected in the second and third-trimester placenta, as well as CRP, FBG, TC, TG, HDL-C, LDL-C and FINS. At the same time, BMI and insulin resistance index （ HOMA- IRI） were also calculated. Results （ 1 ） The serum TC, TG, LDL-C and HOMA-IRI of 82 women were significantly increased in third-trimester compared with those in second-trimester. However, there was no difference in serum CRP between two periods. Significant positive linear correlation was revealed in 82 women between CRP and HOMA- IRI, TG in second- trimester （ r = 0. 408, P 〈 0.01 ; r = 0. 257, P 〈 0.05）. （2） Significantly increased serum CRP, TG and HOMA-IRI were found in GDM women in second-trimester compared with those in both GIGT women and NGT women （ P 〈 0. 05 ）. （ 3 ） In all three groups, the serum CRP were positively correlated with HOMA-IRI and TG in second -trimester,especially significant in GDM women（ r =0. 422, P 〈 0.05 ;r = 0. 380 ,P 〈 0.05 ）. Conclusion The increasing levels of serum CRP are correlative to the insulin resistance and lipid metabolic disorder in pregnant women with varying glucose tolerances in second -trimester, especially in GDM women.