Zhu Chunyan, Yang Hongling, Geng Qingshan, Ma Qingling, Long Yan, Zhou Cheng, Chen Ming
Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China.
Department of Laboratory, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, 510623, China.
PLoS One. 2015 Apr 27;10(4):e0126490. doi: 10.1371/journal.pone.0126490. eCollection 2015.
The relationship between gestational diabetes mellitus (GDM) and oxidative stress has not been fully elucidated. This study examined the association between biomarkers of oxidative stress and GDM.
We conducted a case-control study which included 36 women presenting with GDM and 36 asymptomatic matched control subjects who visited Guangzhou Women and Children's Medical Centre, China, from June 2012 to December 2012. Pregnant women were prospectively recruited to the study, and blood samples were collected at the time of a routine oral glucose tolerance test. These samples were then analyzed for levels of endocrine and surrogate markers of oxidative stress.
Compared to control subjects, women with GDM exhibited elevated values for plasma glucose, insulin, and insulin resistance (IR), and showed reduced HOMA pancreatic β-cell function (HOMA-B), insulin sensitivity index (ISI), insulinogenic index, and corrected insulin response at 24-28 weeks gestation. A bivariate logistic regression analysis showed that levels of high-sensitivity C reactive protein (hs-CRP) and high fluorescence reticulocytes at fasting, and hs-CRP in a 1-h OGTT, were significantly associated with GDM. A linear regression analysis showed that levels of hs-CRP (P = 0.003) and reticulocytes (P = 0.029) at fasting were associated with IR, and levels of hs-CRP (P = 0.002) and monocytes (P = 0.006) in a 1-h OGTT were associated with ISI.
Pregnant women with GDM developed a pathological IR and exhibited β-cell dysfunction. Their decreased ability to compensate for oxidative stress was associated with increased IR and a reduced ISI, which might be important factors in GDM.
妊娠期糖尿病（GDM）与氧化应激之间的关系尚未完全阐明。本研究探讨氧化应激生物标志物与GDM之间的关联。
我们进行了一项病例对照研究，纳入了2012年6月至2012年12月期间在中国广州妇女儿童医疗中心就诊的36例GDM孕妇和36例无症状匹配对照者。前瞻性招募孕妇参与研究，并在常规口服葡萄糖耐量试验时采集血样。然后对这些样本进行氧化应激的内分泌和替代标志物水平分析。
与对照者相比，GDM孕妇的血糖、胰岛素和胰岛素抵抗（IR）值升高，且在妊娠24 - 28周时，其稳态模型评估的胰岛β细胞功能（HOMA - B）、胰岛素敏感性指数（ISI）、胰岛素生成指数和校正胰岛素反应降低。二元逻辑回归分析显示，空腹时高敏C反应蛋白（hs - CRP）和高荧光网织红细胞水平，以及1小时口服葡萄糖耐量试验中的hs - CRP水平与GDM显著相关。线性回归分析显示，空腹时hs - CRP（P = 0.003）和网织红细胞水平（P = 0.029）与IR相关，1小时口服葡萄糖耐量试验中hs - CRP（P = 0.002）和单核细胞水平（P = 0.006）与ISI相关。
GDM孕妇出现病理性IR并表现出β细胞功能障碍。她们补偿氧化应激的能力下降与IR增加和ISI降低有关，这可能是GDM的重要因素。
