Wu Dongya
Department of Obstetrics and Gynecology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China.
Saudi J Biol Sci. 2019 Dec;26(8):2022-2025. doi: 10.1016/j.sjbs.2019.08.009. Epub 2019 Aug 9.
To elaborate how the viral load of HBV affects the gestational diabetes mellitus (GDM).
We enrolled 196 chronic HBV-infected pregnant patients in this hospital between January 2012 and December 2017 for delivery in this study. According to the viral load of HBV-DNA, these patients were divided into the HBV-DNA negative group (n = 107, <1 × 10 copies/mL) and HBV-DNA positive group (n = 89, ≥1 × 10 copies/mL). Simultaneously, 100 HBV-free pregnant women who were admitted to the hospital for delivery were included in the control group. Before delivery, fasting venous blood was drawn from the pregnant women to perform the HBV-DNA quantification through qRT-PCR; from the 24th to 28th gestation week, all pregnant women underwent OGTT, with the third-trimester-of-pregnancy as the endpoint. Besides, we also measured the FBG, 2hPG and hemoglobin A1c (HbAIc).
Among 168 pregnant patients carrying chronic HBV, viral load of 107 patients was less than 1 × 10 copies/mL (54.6%), and 89 not less than 1 × 10 copies/mL (45.4%). The incidence rates of GDM in the HBV-DNA negative group and HBV-DNA positive group were 18.7% and 19.1%, respectively, significantly higher than that in the control group ( < 0.05), while the difference of the incidence rates of GDM between two HBV-DNA groups were not significant ( > 0.05). In HBV-DNA negative group and HBV-DNA positive group, FBGs, 2hPGs and HbAIcs were respectively (6.96 ± 0.36) mmol/L and (7.04 ± 0.37) mmol/L, (10.26 ± 1.29) mmol/L and (10.16 ± 1.12) mmol/L, and (8.66 ± 0.97) % and (8.91 ± 0.90) %, significantly higher than (4.57 ± 0.34) mmol/L, (6.16 ± 0.86) mmol/L and (5.13 ± 0.57) % ( < 0.05); however, between two HBV-DNA groups, comparisons of the FBG, 2hPG and HbAIc suggested no significant differences ( > 0.05). In 196 patients carrying chronic HBV, positive correlations were identified between the viral load of HBV-DNA, and FBG, 2hPG and HbAIc ( < 0.01).
HBV infection can increase the incidence rate of GDM, and the viral load of HBV-DNA is correlated with the glucose level of pregnant patients.
阐述乙型肝炎病毒(HBV)载量如何影响妊娠期糖尿病(GDM)。
2012年1月至2017年12月期间,我们纳入了本院196例慢性HBV感染的孕妇进行本研究分娩。根据HBV-DNA病毒载量,将这些患者分为HBV-DNA阴性组(n = 107,<1×10拷贝/mL)和HBV-DNA阳性组(n = 89,≥1×10拷贝/mL)。同时,将100例因分娩入院的非HBV感染孕妇纳入对照组。分娩前,采集孕妇空腹静脉血,通过qRT-PCR进行HBV-DNA定量;妊娠第24至28周,所有孕妇均行口服葡萄糖耐量试验(OGTT),以妊娠晚期为终点。此外,我们还测量了空腹血糖(FBG)、餐后2小时血糖(2hPG)和糖化血红蛋白(HbAIc)。
168例携带慢性HBV的孕妇中,107例病毒载量小于1×10拷贝/mL(54.6%),89例不小于1×10拷贝/mL(45.4%)。HBV-DNA阴性组和HBV-DNA阳性组的GDM发病率分别为18.7%和19.1%,显著高于对照组(<0.05),而两个HBV-DNA组之间的GDM发病率差异无统计学意义(>0.05)。在HBV-DNA阴性组和HBV-DNA阳性组中,FBG、2hPG和HbAIc分别为(6.96±0.36)mmol/L和(7.04±0.37)mmol/L,(10.26±1.29)mmol/L和(10.16±1.12)mmol/L,以及(8.66±0.97)%和(8.91±0.90)%,显著高于对照组的(4.57±0.34)mmol/L、(6.16±0.86)mmol/L和(5.13±0.57)%(<0.05);然而,两个HBV-DNA组之间,FBG、2hPG和HbAIc的比较差异无统计学意义(>0.05)。在196例携带慢性HBV的患者中,HBV-DNA病毒载量与FBG、2hPG和HbAIc之间呈正相关(<0.01)。
HBV感染可增加GDM的发病率,且HBV-DNA病毒载量与孕妇血糖水平相关。