妊娠期糖尿病合并低维生素D孕妇血清IGF-1、炎性因子表达

Expression and significance of serum insulin like growth factor-1 and inflammatory factors of pregnant women with gestational diabetes mellitus complicated with low vitamin D status

目的:探讨妊娠期糖尿病(GDM)孕妇孕中期血清25羟维生素D(25-(OH)D)与胰岛素样生长因子1(IGF-1)、炎性因子分泌的相关性。方法:2020年6月-2021年4月本院诊断为GDM孕妇为研究对象,根据血清25-(OH)D水平,分为维生素D缺乏组[25-(OH)D<50nmol/l]、不足组[50≤25-(OH)D<75nmol/l]及对照组[25-(OH)D≥75nmol/l]。采集孕24~28周时空腹静脉血,测定IGF-1、白细胞介素-6(IL-6)、肿瘤坏死因子-a(TNF-a)的水平。结果:维生素D缺乏组和不足组中IL-6、TNF-a水平均高于对照组,且缺乏组IL-6,TNF-a水平高于不足组(P均<0.05);IGF-1的表达低于不足组和对照组(P<0.05),而不足组与对照组无差异(P>0.05);维生素D缺乏组和不足组IL-6、TNF-a与25-(OH)D均呈负相关(r=-0.71~-0.58),维生素D缺乏组IGF-1与25-(OH)D呈正相关(r=0.51)。结论:孕妇孕中期维生素D不足和缺乏与GDM发病有关,其发病机制可能与其调控IGF-1及炎症因子IL-6、TNF-a的分泌紊乱有关。

Objective:To explore the relationship between the level of serum 25-hydroxyvitamin D(25-(OH)D)of pregnant women with gestational diabetes mellitus(GDM)during the second trimester of pregnancy and the levels of their insulin like growth factor-1(IGF-1)and inflammatory factors.Methods:The pregnant women with GDM were selected and divided into group A(women with serum 25-(OH)D<50nmol/L),group B(women with serum 50≤25-(OH)D<75nmol/L),and group C(women with serum 25-(OH)D≥75nmol/L)from June 2020 to April 2021.The fasting venous blood of the women in the three groups during 24-28 gestational weeks was collected for detecting the levels of their IGF-1,interlleukin-6(IL-6),and tumor necrosis factor-A(TNF-A).Results:The levels of IL-6 and TNF-A of the women in group A and group B were significantly higher than those of the women in group C,and which of the women in group A were significantly higher than those of the women in group B(P<0.05).The expression of IGF-1 level of the women in group A was significantly lower than that of the women in group B and group C(P<0.05),but which of the women had no significant different between group B and group C(P>0.05).The levels of IL-6 and TNF-A of the women in group A and group B were negatively correlated with their 25-(OH)D level(r=-0.71--0.58,all P<0.05),and the IGF-1 level of the women in group A was positively correlated with their 25-(OH)D level(r=0.51,P<0.05).Conclusion:The deficiency and deficiency of Vitamin D of the pregnant women during the second trimester of pregnancy are related to their GDM occurrence,and its pathogenesis may be related to the regulation of the IGF-1 level and the secretion disorder of inflammatory factors of IL-6 and TNF-A.