Di Cianni G, Lencioni C, Volpe L, Ghio A, Cuccuru I, Pellegrini G, Benzi L, Miccoli R, Del Prato S
Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, University of Pisa and Azienda Ospedaliera Pisana, Pisa, Italy.
Diabetes Metab Res Rev. 2007 Feb;23(2):135-40. doi: 10.1002/dmrr.661.
This study evaluates the presence of metabolic syndrome (MS) and its association with C-reactive protein (CRP) and other cardiovascular (CV) risk factors, in a sample of women with and without previous Gestational Diabetes (pGDM).
One hundred and sixty-six women with pGDM and 98 women (controls) with uncomplicated pregnancy were studied 16 months after delivery. In all women, plasma glucose, insulin, lipid profile, serum uric acid, C-reactive protein, fibrinogen and homocysteine were measured. MS was defined according to NCEP ATPIII criteria.
MS was identified in 15 pGDM women (9%) versus 1 control (1%) (p < 0.001). The more frequent metabolic traits were abdominal obesity (36% vs 17%) and low HDL-cholesterol (34% vs 17% in pGDM women and controls, respectively; all p < 0.01). HOMA-R, LDL-cholesterol, fibrinogen, serum uric acid and CRP resulted significantly higher in pGDM women with MS as compared to those without MS after adjustment for BMI. In women with no criteria for MS, only CRP levels were found to be higher in pGDM women compared to controls (p < 0.05). Seventeen percent of pGDM women with no criteria for MS had CRP levels >or=1 mg/L (all controls showed CRP levels <1 mg/L). After a stepwise regression analysis, CRP levels were independently correlated to HOMA-R (r2 = 0.27, p < 0.001) and fibrinogen (r2 = 0.30, p < 0.001).
In our population, MS occurs in a sizable proportion of pGDM women and is associated with increased levels of CRP, fibrinogen, uric acid and LDL-cholesterol. Moreover, higher levels of CRP, a marker of chronic low-grade inflammation, are present in a subset of women with pGDM, independently of MS.
本研究评估了有或无既往妊娠糖尿病（pGDM）的女性样本中代谢综合征（MS）的存在情况及其与C反应蛋白（CRP）和其他心血管（CV）危险因素的关联。
对166例患有pGDM的女性和98例妊娠无并发症的女性（对照组）在分娩后16个月进行了研究。检测了所有女性的血糖、胰岛素、血脂谱、血清尿酸、C反应蛋白、纤维蛋白原和同型半胱氨酸。MS根据NCEP ATPIII标准定义。
15例pGDM女性（9%）被诊断为MS，而对照组为1例（1%）（p<0.001）。更常见的代谢特征是腹型肥胖（36%对17%）和高密度脂蛋白胆固醇降低（pGDM女性和对照组分别为34%对17%；所有p<0.01）。在校正体重指数后，与无MS的pGDM女性相比，患有MS的pGDM女性的胰岛素抵抗指数（HOMA-R）、低密度脂蛋白胆固醇、纤维蛋白原、血清尿酸和CRP显著更高。在无MS标准的女性中，与对照组相比，仅发现pGDM女性的CRP水平更高（p<0.05）。17%无MS标准的pGDM女性的CRP水平≥1mg/L（所有对照组的CRP水平<1mg/L）。经过逐步回归分析，CRP水平与HOMA-R（r2=0.27，p<0.001）和纤维蛋白原（r2=0.30，p<0.001）独立相关。
在我们的研究人群中，相当一部分pGDM女性患有MS，且与CRP、纤维蛋白原、尿酸和低密度脂蛋白胆固醇水平升高有关。此外，在一部分pGDM女性中存在较高水平的CRP，这是慢性低度炎症的标志物，且独立于MS。
