妊娠期糖尿病宫内高血糖环境对子代外周炎症反应的影响

Influence of Intrauterine Hyperglycemia Environment on Peripheral Inflammatory Response in Offspring of Gestational Diabetes Mellitus

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM))宫内高血糖环境对子代脐血外周炎症反应的影响。方法选择2019年11月至2023年5月在昆明医科大学第一附属医院出生的GDM母亲及孕期血糖正常母亲的子代作为研究对象,其中选择孕期血糖控制良好的GDM组108例,男67例,女41例,对照组150例,男82例,女68例。采用流式CBA技术测定脐静脉血血清(IL-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-17、TNF-α、IFN-α、IFN-γ及IL-12P70)水平。结果GDM组脐静脉血血清IL-6、IL-8、TNF-α水平高于对照组,差异有统计学意义[(6.65±0.51)vs(4.02±0.40),P=0.007;(13.96±1.10)vs(7.36±0.50),P=0.040;(1.27±0.10)vs(0.56±0.01),P=0.020]。GDM组IFN-γ水平低于对照组[(5.67±0.50)vs(10.54±0.90),P=0.038]。GDM组脐静脉血血清IL-1β、IL-2、IL-4、IL-5、IL-10、IL-12P70、IL-17、IFN-α与对照组相比,差异无统计学意义(P>0.05)。结论孕期血糖控制良好的GDM子代先天免疫系统仍被过度激活,并过度释放促炎症因子IL-6、IL-8、TNF-α,这将为进一步明确GDM宫内高血糖环境子代外周先天免疫系统被激活是否会诱导脑内神经炎症的发生的研究提供了临床依据及基础。

Objective To explore the effect of intrauterine hyperglycemia on peripheral inflammatory reaction of cord blood of offspring with gestational diabetes mellitus(GDM).Methods The objects of this study were the offspring of women who delivered in the first affiliated hospital of Kunming Medical University from November 2019 to May 2023.The GDM group included 108 infants(67 male cases and 41 female cases)of mothers with GDM.The control group included 150 infants(82 male cases and 68 female cases)of women with normal glucose tolerance.The concentrations of umbilical vein blood serum IL-1β,IL-2,IL-4,IL-5,IL-6,L-8,IL-10,IL-17,TNF-α,IFN-α,IFN-γand IL-12P70 were measured by flow cytometry CBA technology.Results The levels of vein cord blood serum pro-inflammatory factors IL-6,IL-8 and TNF-αwere higher than the control group,the differences was statistical(6.65±0.51 vs 4.02±0.40,P=0.007;13.96±1.10 vs 7.36±0.50,P=0.040;1.27±0.10 vs 0.56±0.01,P=0.020).The level of IFN-γwas lower than the control group(5.67±0.50 vs 10.54±0.90,P=0.038),the differences were statistical.There was no differences in the levels of IL-1β,IL-2,IL-4,IL-5,IL-10,IL-12P70,IL-17,IFN-α.Conclusion Even in GDM offspring with good blood sugar control during pregnancy,the innate immune system is overactivated,and proinflammatory factors IL-6,IL-8,and TNF-αare released excessively,laying a clinical foundation for further understanding whether the activation of the peripheral innate immune system in the GDM intrauterine hyperglycemic environment can induce the occurrence of neuroinflammation in the brain and its contribution in neuroinflammation.