Gugapriya T S, Karthick S, Nagarjuna B
Associate Professor, Department of Anatomy, Chennai Medical College Hospital and Research Centre , Trichy, India .
Assistant Professor, Department of Anatomy, Melmaruvathur Adiparasakthi Institute of Medical Sciences and Research , Melmaruvathur, India .
J Clin Diagn Res. 2014 Apr;8(4):CC01-4. doi: 10.7860/JCDR/2014/8118.4240. Epub 2014 Apr 15.
Diabetes mellitus (DM) is one of the metabolic syndromes prevalent worldwide, with more concentration in the Asian region. Many studies have been conducted in order to understand the complex pathogenesis of this disease. Yet, there exists a lacuna in our knowledge about DM. This study aims at establishing the reason for glycemic variation in menstruating Type-2 diabetic women by estimation of C-reactive protein, an inflammatory marker that exhibits significant association with changes in blood glucose levels.
A prospective study was undertaken in Type-2 diabetic women of reproductive age group to assess the variability of glycemic control during different phases of menstrual cycle using high sensitivity C reactive protein (hs-CRP) as the biomarker. Fifty women were enrolled after satisfying a set of inclusion and exclusion criteria. The fasting blood glucose, hs-CRP concentration and endogenous female hormones were assayed in follicular and luteal phases of the cycle. The observed parameters were analyzed statistically for significant correlation. Observation and Result: The result showed that hs-CRP level significantly correlates with increasing levels of fasting blood glucose level in both the phases of menstrual cycle in Type-2 diabetic women. The significance is statistically stronger during luteal phase of the cycle (r = 0.807; p<0.05). The correlation observed between hs-CRP and Estrodiol in follicular phase (r = -0.311; p < 0.05) was not statistically significant. The hs-CRP level increased significantly with progesterone level during luteal phase (r = 0.826; p <0.05).
This study concludes that Type-2 diabetic women of reproductive age group encounter a period of poor glycemic control during luteal phase, as shown by statistically high hs-CRP level mediated by endogenous progesterone hormone. Therefore, this study advocates careful monitoring, life style adjustments and drug regime to reduce the fluctuation in glycemic level experienced by Type-2 diabetic premenopausal women in the luteal phase.
糖尿病（DM）是全球流行的代谢综合征之一，在亚洲地区更为集中。为了解这种疾病的复杂发病机制，已经进行了许多研究。然而，我们对糖尿病的认识仍存在空白。本研究旨在通过估计C反应蛋白来确定2型糖尿病女性在月经期间血糖变化的原因，C反应蛋白是一种炎症标志物，与血糖水平变化存在显著关联。
对育龄期2型糖尿病女性进行前瞻性研究，以高敏C反应蛋白（hs-CRP）作为生物标志物，评估月经周期不同阶段血糖控制的变异性。在满足一组纳入和排除标准后，招募了50名女性。在月经周期的卵泡期和黄体期测定空腹血糖、hs-CRP浓度和内源性女性激素。对观察到的参数进行统计学分析，以确定显著相关性。
结果表明，在2型糖尿病女性月经周期的两个阶段，hs-CRP水平均与空腹血糖水平的升高显著相关。在月经周期的黄体期，这种相关性在统计学上更强（r = 0.807；p<0.05）。在卵泡期观察到的hs-CRP与雌二醇之间的相关性（r = -0.311；p < 0.05）在统计学上不显著。在黄体期，hs-CRP水平随孕酮水平显著升高（r = 0.826；p <0.05）。
本研究得出结论，育龄期2型糖尿病女性在黄体期会经历血糖控制不佳的时期，内源性孕酮激素介导的hs-CRP水平在统计学上较高即表明了这一点。因此，本研究主张进行仔细监测、调整生活方式和药物治疗方案，以减少绝经前2型糖尿病女性在黄体期经历的血糖水平波动。
