Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria.
Eur J Clin Invest. 2010 Apr;40(4):339-43. doi: 10.1111/j.1365-2362.2010.02274.x.
Gestational diabetes (GDM) is an increasing and common complication of pregnancy. The involvement of inflammatory mechanisms in GDM remains unclear. YKL-40 is a novel inflammatory marker that has been recently found to be associated with type 2 diabetes. This is the first study to investigate YKL-40 in GDM.
A total of 58 subjects were included, 28 patients with GDM (BMI 33.2 +/- 6.1 kg m(-(2)), 33 +/- 6 years) and 30 healthy pregnant controls (BMI 28.4 +/- 5.2 kg m(-(2)), 33 +/- 4 years; mean +/- SD). Standard risk factors for GDM (weight and BMI prior to pregnancy, family history, former GDM, high birthweight offspring) were evaluated. A 2-h 75-g oral glucose tolerance test (oGTT) and measurement of YKL-40 were conducted in gestational week 28 +/- 4, as well as 8 weeks after delivery.
YKL-40 was not different between GDM and controls, neither during (65.8 +/- 44.4 vs. 60.3 +/- 30.1 ng mL(-1)), nor after pregnancy (63.4 +/- 30.5 vs. 66.9 +/- 32.7 ng mL(-1)). YKL-40 was correlated with insulin, HOMA and BMI. GDM had higher fasting insulin (14.1 +/- 7.4 vs. 8.3 +/- 4.3 muU mL(-1)) and glucose (88 +/- 13 - 200 +/- 31 - 160 +/- 33 vs. 76 +/- 10 - 146 +/- 37 - 112 +/- 28 mg dL(-1) for fasting, 1- and 2-h-concentrations in the oGTT, respectively), higher HbA1c (5.3 +/- 0.4 vs. 5.0 +/- 0.5%;), HOMA (3.1 +/- 1.7 vs. 1.6 +/- 0.9), and BMI (33.2 +/- 6.1 vs. 28.5 +/- 5.2 kg m(-2)) (means +/- SD, all P < 0.01).
No difference in YKL-40 between GDM and controls suggests similar inflammatory status at the time of measurements. The short duration of metabolic changes during GDM might explain this finding, which is in contrast to results in type 2 diabetes.
妊娠糖尿病（GDM）是一种日益常见的妊娠并发症。炎症机制在 GDM 中的作用尚不清楚。YKL-40 是一种新型炎症标志物，最近发现与 2 型糖尿病有关。这是第一项研究 GDM 中 YKL-40 的研究。
共纳入 58 例受试者，其中 28 例 GDM 患者（BMI 33.2 +/- 6.1 kg m(-(2))，33 +/- 6 岁）和 30 例健康孕妇对照（BMI 28.4 +/- 5.2 kg m(-(2))，33 +/- 4 岁；均值 +/- SD）。评估了 GDM 的标准危险因素（妊娠前体重和 BMI、家族史、既往 GDM、高出生体重儿）。在妊娠 28 +/- 4 周和产后 8 周进行 2 小时 75 g 口服葡萄糖耐量试验（oGTT）和 YKL-40 测量。
GDM 患者和对照组之间的 YKL-40 无差异，无论是在怀孕期间（65.8 +/- 44.4 vs. 60.3 +/- 30.1 ng mL(-1))，还是在怀孕后（63.4 +/- 30.5 vs. 66.9 +/- 32.7 ng mL(-1))。YKL-40 与胰岛素、HOMA 和 BMI 相关。GDM 患者空腹胰岛素（14.1 +/- 7.4 vs. 8.3 +/- 4.3 muU mL(-1))和血糖（88 +/- 13 - 200 +/- 31 - 160 +/- 33 vs. 76 +/- 10 - 146 +/- 37 - 112 +/- 28 mg dL(-1)，oGTT 的空腹、1 小时和 2 小时浓度）、HbA1c（5.3 +/- 0.4 vs. 5.0 +/- 0.5%）、HOMA（3.1 +/- 1.7 vs. 1.6 +/- 0.9）和 BMI（33.2 +/- 6.1 vs. 28.5 +/- 5.2 kg m(-2))（均为均值 +/- SD，均 P < 0.01）更高。
GDM 患者和对照组之间的 YKL-40 无差异表明在测量时具有相似的炎症状态。GDM 期间代谢变化的持续时间较短可能解释了这一发现，这与 2 型糖尿病的结果相反。
