Alamolhoda Seideh Hanieh, Yazdkhasti Mansoreh, Namdari Mahshid, Zakariayi Seyed Jafar, Mirabi Parvaneh
Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Department of Midwifery, School of Medicine, Alborz university of Medical Sciences, Karaj, Iran.
J Obstet Gynaecol. 2020 Apr;40(3):349-353. doi: 10.1080/01443615.2019.1631767. Epub 2019 Sep 9.
Studies that examined the impacts of inflammatory factors on gestational diabetes mellitus (GDM) are very sparse. The purpose of this study was to investigate the relationship between C-reactive protein (CRP) and the risk of GDM. Pregnant women who fulfilled the inclusion criteria and their gestational ages were below 10 weeks were recruited to this cohort study and were followed up until the 24-28 weeks of gestation. At the first pre-natal care visit blood samples were taken from all the pregnant women to investigate the serum concentration of CRP and fasting blood sugar. At 24-28 weeks of gestation, an oral glucose tolerance test was done to diagnose GDM as routine. About 5% of the women participating in the study were diagnosed as having GDM. There was a significant association between the increased serum concentration of CRP in the first trimester and the risk of GDM. The risk of GDM in women with the highest serum concentration of CRP is three times higher than that of women with the lowest serum concentration of CRP. Systemic inflammation can be associated with increased risk of gestational diabetes.Impact statement Multiple studies have shown that chronic inflammation can increase the risk of developing type2 diabetes. There is incertitude as to the best attitude for screening and diagnosis of GDM. The studies were examined the impacts of inflammatory factors on GDM is very restricted. CRP level measurement in the first trimester can be considered as a screening test. This is an easy and cost-effective test to make decision for performing oral glucose tolerance test at 24-28 weeks of pregnancy. The results of this study could give physicians and other health care providers the hint that increasing serum CRP levels in early pregnancy can be a risk factor for gestational diabetes.
研究炎症因子对妊娠期糖尿病（GDM）影响的相关研究非常少。本研究的目的是调查C反应蛋白（CRP）与GDM风险之间的关系。纳入符合纳入标准且孕周小于10周的孕妇参与本队列研究，并随访至妊娠24 - 28周。在首次产前检查时，采集所有孕妇的血样以检测血清CRP浓度和空腹血糖。在妊娠24 - 28周时，进行口服葡萄糖耐量试验以常规诊断GDM。参与研究的女性中约5%被诊断为患有GDM。孕早期血清CRP浓度升高与GDM风险之间存在显著关联。血清CRP浓度最高的女性患GDM的风险是血清CRP浓度最低的女性的三倍。全身炎症可能与妊娠期糖尿病风险增加有关。影响声明多项研究表明，慢性炎症会增加患2型糖尿病的风险。对于GDM的筛查和诊断的最佳方式存在不确定性。研究炎症因子对GDM影响的研究非常有限。孕早期测量CRP水平可被视为一种筛查试验。这是一种简单且经济有效的试验，可为在妊娠24 - 28周时是否进行口服葡萄糖耐量试验提供决策依据。本研究结果可为医生和其他医疗保健提供者提供提示，即孕早期血清CRP水平升高可能是妊娠期糖尿病的一个风险因素。
