GDM孕妇妊娠早期炎症因子、血糖水平检测及临床意义

Detection and clinical significance of inflammatory factors and blood glucose levels in pregnant women with gestational diabetes mellitus in early pregnancy

目的检测妊娠期糖尿病(GDM)孕妇妊娠早期的炎症因子、血糖水平并探讨其临床意义。方法回顾性分析2019年10月至2021年12月上海中冶医院诊治的113例GDM孕妇(GDM组)的临床资料,另选择同期在本院产检的健康孕妇100例作为对照组。检测并比较两组孕妇妊娠早期炎症因子[超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子(TNF-α)]和空腹血糖(FBG)水平。采用Spearman相关性分析法分析GDM孕妇妊娠早期炎症因子水平与FBG的相关性,并采用多元Logistic回归分析对GDM的危险因素进行分析。结果GDM组孕妇的hs-CRP、IL-6、TNF-α、FBG水平分别为(6.49±1.31)mg/L、(173.98±21.16)pg/mL、(6.78±0.91)pg/m L、(5.02±0.26)mmol/L,明显高于对照组的(3.30±0.82)mg/L、(89.25±15.37)pg/m L、(3.65±0.54)pg/m L、(4.86±0.22)mmol/L,IL-10水平为(67.25±7.24)pg/mL,明显低于对照组的(86.43±9.33)pg/mL,差异均有统计学意义(P<0.05);经Spearman相关分析结果显示,GDM孕妇妊娠早期hs-CRP、IL-6、TNF-α水平与FBG呈正相关(r=0.437、0.637、0.601,P<0.05),IL-10水平与FBG呈负相关(r=-0.329,P<0.05);经多元Logistic回归分析结果显示,hs-CRP、IL-6、IL-10、TNF-α为GDM的独立危险因素(P<0.05)。结论GDM孕妇妊娠早期hs-CRP、IL-6、TNF-α、FBG水平明显较高,IL-10水平明显较低,且hs-CRP、IL-6、IL-10、TNF-α是GDM的独立危险因素。

Objective To detect inflammatory factors and blood glucose levels in pregnant women with gestational diabetes mellitus(GDM)in early pregnancy and explore their clinical significance.Methods The clinical data of113 pregnant women with GDM(GDM group)diagnosed and treated in Shanghai MCC Hospital from October 2019to December 2021 were retrospectively analyzed,and 100 healthy pregnant women who underwent obstetric examination in the hospital during the same period were selected as the control group.The inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),IL-10,tumor necrosis factorα(TNF-α)]and fasting blood glucose(FBG)in early pregnancy of pregnant women of the two groups were detected and compared.Spearman correlation analysis was used to analyze the correlation between the levels of inflammatory factors and FBG in pregnant women with GDM in early pregnancy,and multivariate Logistic regression analysis was used to analyze the risk factors of GDM.Results The levels of hs-CRP,IL-6,TNF-α,and FBG in GDM group were(6.49±1.31)mg/L,(173.98±21.16)pg/mL,(6.78±0.91)pg/mL,(5.02±0.26)mmol/L,significantly higher than(3.30±0.82)mg/L,(89.25±15.37)pg/mL,(3.65±0.54)pg/mL,(4.86±0.22)mmol/L in the control group,and IL-10 level was(67.25±7.24)pg/mL,which was significantly lower than(86.43±9.33)pg/mL of the control group,with statistically significant difference(P<0.05).Spearman correlation analysis showed that the levels of hs-CRP,IL-6,and TNF-αin early pregnancy of GDM pregnant women were positively correlated with FBG(r=0.437,0.637,0.601,all P<0.05),and the levels of IL-10 were negatively correlated with FBG(r=-0.329,P<0.05).Logistic regression analysis showed that hs-CRP,IL-6,IL-10,and TNF-αwere independent risk factors for GDM(P<0.05).Conclusion Compared with healthy pregnant women,pregnant women with GDM had significantly higher levels of hs-CRP,IL-6,TNF-α,and FBG in early pregnancy,while significantly lower IL-10 levels.hs-CRP,IL-6,IL-10,and TNF-αwere independent risk factors of GDM.