妊娠糖尿病患者外周血细胞焦亡相关因子的表达及与胰岛素抵抗的关系

Expression of pyrolysis-related factors in peripheral blood cells of patients with gestational diabetes and its relationship with insulin resistance

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清细胞焦亡相关因子半胱氨酸蛋白酶-1(caspase-1)、白介素-18(IL-18)水平及其与胰岛素抵抗(IR)的关系。方法选取2019年4月至2021年3月开封市中医院收治的GDM患者102例为GDM组,纳入同期产检健康孕妇102例为正常组。比较GDM组与正常组孕妇年龄、孕周、空腹胰岛素(FINS)、孕前体重指数(BMI)、甘油三酯(TG)、空腹血糖(FBG)、总胆固醇(TC)、稳态模型胰岛素抵抗指数(HOMA-IR)等资料;酶联免疫吸附法(ELISA)检测血清caspase-1、IL-18水平;Pearson法分析GDM患者血清caspase-1、IL-18水平与HOMA-IR的相关性;Logistic回归法分析GDM发生的影响因素。结果GDM组患者TG[(2.94±0.99)mmol/L vs(2.09±0.70)mmol/L]、FBG[(5.87±1.94)mmol/L vs(4.90±1.67)mmol/L]、TC[(5.72±1.92)mmol/L vs(5.03±1.68)mmol/L]、FINS[(11.45±3.87)mIU/L vs(6.92±2.34)mIU/L]、HOMA-IR水平[(3.05±0.78)vs(1.51±0.40)]及血清caspase-1[(86.27±28.78)pg/ml vs(40.98±13.54)pg/ml]、IL-18水平[(44.26±14.56)pg/L vs(30.45±10.12)pg/L]高于正常组(t=7.080、3.827、2.731、10.116、17.743、14.381、7.866,P<0.05);GDM患者血清caspase-1、IL-18水平与HOMA-IR呈正相关(r=0.518、0.555,P<0.05);FBG、TG、FINS、HOMA-IR、caspase-1、IL-18是影响GDM发生的危险因素(95%CI=1.578~3.826、1.454~3.311、1.477~3.405、1.678~4.265、1.406~3.141、1.511~3.551,P<0.05)。结论GDM患者血清caspase-1、IL-18水平较高,均与IR显著相关,caspase-1、IL-18可能是治疗GDM的潜在靶标。

Objective To investigate the levels of serum pyrolysis-related factors cysteine protease-1(caspase-1)and interleukin-18(IL-18)in patients with gestational diabetes mellitus(GDM)and their relationship with insulin resistance(IR).Methods A total of 102 GDM patients admitted to Kaifeng Traditional Chinese Medicine Hospital from Apr.2019 to Mar.2021 were selected as the GDM group,and 102 healthy pregnant women undergoing obstetric examination in the same period were included as the normal group.The age,gestational week,fasting insulin(FINS),pre-pregnancy body mass index(BMI),triglycerides(TG),fasting blood glucose(FBG),total cholesterol(TC),and homeostatic model insulin resistance index(HOMA-IR)and other materials were compared between the GDM group and the normal group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum caspase-1 and IL-18;Pearson method was used to analyze the correlation between serum caspase-1 and IL-18 levels and HOMA-IR in GDM patients;Logistic regression method was used to analyze the influencing factors of GDM.Results The levels of TG[(2.94±0.99)mmol/L vs(2.09±0.70)mmol/L],FBG[(5.87±1.94)mmol/L vs(4.90±1.67)mmol/L],TC[(5.72±1.92)mmol/L vs(5.03±1.68)mmol/L],FINS[(11.45±3.87)mIU/L vs(6.92±2.34)mIU/L],HOMA-IR[(3.05±0.78)vs(1.51±0.40)]and levels serum caspase-1[(86.27±28.78)pg/mL vs(40.98±13.54)pg/mL]and IL-18[(44.26±14.56)pg/L vs(30.45±10.12)pg/L]in the GDM group were higher than those in the normal group(t=7.080,3.827,2.731,10.116,17.743,14.381,7.866,P<0.05);the levels of serum caspase-1 and IL-18 in GDM patients were positively correlated with HOMA-IR(r=0.518,0.555,P<0.05);FBG,TG,FINS,HOMA-IR,caspase-1,IL-18 were risk factors affecting the occurrence of GDM(95%CI=1.578-3.826,1.454-3.311,1.477-3.405,1.678-4.265,1.406-3.141,1.511-3.551,P<0.05).Conclusions The levels of serum caspase-1 and IL-18 in patients with GDM are relatively high,which are significantly related to IR.Caspase-1 and IL-18 may be potential targets for the treatment of GDM.