妊娠期糖尿病孕妇产后血清超敏C反应蛋白及25-羟基维生素D3水平及其临床意义

Postpartum levels and clinical significance of serum high-sensitivity C-reactive protein and 25-hydroxy vitamin D3 in pregnant women with gestational diabetes mellitus

目的 探讨妊娠期糖尿病(GDM)孕妇产后血清超敏C反应蛋白(hs-CRP)、25-羟基维生素D3[25-(OH)D3]水平的变化及其临床意义。方法选取55例GDM孕妇(GDM组)及50例正常孕妇(对照组)。比较两组产后2个月及4个月的血清hs-CRP和25-(OH)D3水平,以及产后2个月的空腹血胰岛素(Fins)、空腹血糖水平及胰岛素抵抗(HOMA-IR)指数。分析GDM组产后2个月血清hs-CRP和25-(OH)D3水平与空腹血糖、HOMA-IR指数的相关性。结果产后2个月、4个月,GDM组血清hs-CRP水平高于正常范围,且高于对照组,25-(OH)D3水平低于正常范围,且低于对照组(均P<0.05)。产后2个月,GDM组的空腹血糖水平、HOMA-IR指数均高于正常范围,且高于对照组(均P<0.05)。GDM组hs-CRP水平与空腹血糖水平、HOMA-IR指数呈正相关,25-(OH)D3水平与空腹血糖水平、HOMA-IR指数、hs-CRP水平呈负相关(均P<0.05)。结论GDM孕妇产后胰岛素抵抗更为明显,且血清hs-CRP水平升高而25-(OH)D3降低,两者或是监测GDM孕妇产后糖代谢异常及胰岛素抵抗的有效指标。

Objective To investigate the postpartum level variance and clinical significance of serum high-sensitivity C-reactive protein(hs-CRP) and 25-hydroxy vitamin D 3[25-(OH)D 3]in pregnant women with gestational diabetes mellitus(GDM). Methods Fifty-five pregnant women with GDM(GDM group) and 50 healthy pregnant women(control group) were enrolled.The two groups were compared with respect to serum hs-CRP and 25-(OH)D 3 levels at 2 and 4 months after delivery,as well as fasting insulin(Fins) and FBG levels and homeostasis model assessment for insulin resistance (HOMA-IR) index at month 2 postpartum.Two months after delivery,the correlation of serum hs-CRP and 25-(OH)D 3 levels with FBG or HOMA-IR index was analyzed in the GDM group. Results Two and 4 months after delivery,the GDM group reported a higher serum hs-CRP level than the normal limit or the control group,and a lower 25-(OH)D 3 level than the normal limit or the control group(all P <0.05).Two months after delivery,the GDM group exhibited higher FBG level and HOMA-IR index compared with the normal limit or the control group(all P <0.05).In the GDM group,hs-CRP level positively correlated with FBG level or HOMA-IR index,25-(OH)D 3 level negatively correlated with FBG level,HOMA-IR index,or hs-CRP level(all P <0.05). Conclusion After delivery,pregnant women with GDM experience more significant insulin resistance,as well as elevated serum hs-CRP level and reduced 25-(OH)D 3 level, and the later two indices might be the indicators for effectively monitoring glycometabolism abnormality and insulin resistance in pregnant women with GDM.