非肥胖孕妇血清C-反应蛋白水平与妊娠期糖尿病相关性研究

Relationship between C-reactive protein levels and gestational diabetes mellitus in non-obese pregnant women

目的探讨非肥胖孕妇血清C-反应蛋白(CRP)水平与妊娠期糖尿病(GDM)的相关性,了解CRP对妊娠期糖尿病是否存在临床预测意义。方法选取2011年8月至2012年12月大连大学附属中山医院和中山区妇保院孕前基础体重指数均<25的孕妇,分为妊娠期糖尿病组(GDM组)、正常组(NGT组),每组各90例。比较不同组别之间指标的差异及影响血清CRP的相关因素。结果 GDM组血清CRP水平明显高于NGT组,差异有统计学意义(P<0.01)。血清CRP水平与胰岛素抵抗指数、孕期体重增长、空腹血糖、孕前基础体重及孕前体重指数均呈正相关,相关系数分别为0.377、0.333、0.276、0.278、0.300(均为P<0.01)。通过多元线性回归分析,采用Backward法,其CRP(y)的直线回归方程为y=0.323X1+0.1X2+0.244X3-3.918,r2=0.263(X1胰岛素抵抗指数,X2孕期体重增长,X3孕前体重指数)。结论血清C-反应蛋白对妊娠期糖尿病的独立影响不能被证实。控制孕期体重增长有助于预防妊娠期糖尿病的发生。

Objective To analyse the relationship between the level of serum C-reactive protein in non-obese pregnant women and gestational diabetes mellitus.To understanding the clinical predictive significance of CRP in GDM. Methods The body mass index of all the subjects were 〈 25 before pregnancy.This study included non-obese pregnant women with gestational diabetes mellitus（GDM） and non-obese pregnant women without gestational diabetes mellitus （NGT）.The differences in multiple indicators between two groups were compared and the relationship between CRP levels and these indicators was analyzed.Results The levels of CRP in GDM group were significantly higher than in NGT group （P〈0.01）.Two groups had significant differences in statistics.The levels of CRP were positively correlated with the HOMA-IR,the weight gain in pregnancy,the fasting glucose,the body weight before prengnacy and the body mass index before pregnancy.Their regression coefficient was 0.377,0.333,0.276,0.278 and 0.300 respectively（all P〈0.01）.CRP＇s linear regression equation y=0.323X1＋0.1X2＋0.244X3-3.918,r2=0.263 X1HOMA-IR,X2weight gain in pregnancy,X3 the body mass index before pregnancy）. Conclusions The serum CRP level is related to weight gain during pregnancy;it can＇t confirm that CRP is an independent risk factor for GDM.Controlling the weight gain during pregnancy can prevent the GDM.