Tang Mengyang, Luo Mingjuan, Lu Wenqian, Zhang Rong, Liang Wei, Gu Jianfen, Yu Xuemei, Zhang Xueli, Hu Cheng
The Third School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Endocrinology and Metabolism, Fengxian Central Hospital Affiliated to the Southern Medical University, Shanghai, China.
Nutr Metab (Lond). 2020 Nov 19;17(1):98. doi: 10.1186/s12986-020-00523-2.
Inflammation-related factors have been shown to play a significant role throughout pregnancy. In this study, we aimed to explore the relationships between selected inflammatory cytokines and gestational diabetes (GDM) in Chinese pregnant women.
This was a 1:1 matched case-control study that included 200 pairs of subjects in the second trimester and 130 pairs of subjects in the third trimester. Serum levels of nerve growth factor (NGF), Interleukin-6 (IL-6), leptin, Interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α) and Interleukin-1beta (IL-1β) were measured by enzyme immunoassay. The associations of these inflammatory factors with metabolic parameters were analysed.
In the second trimester, GDM patients had higher NGF levels and lower IL-8 levels than did normal controls (P < 0.001 and P = 0.015, respectively). However, in the third trimester, only lower leptin levels were observed in the GDM group (P = 0.031). Additionally, in the second trimester, NGF levels were not only positively associated with fasting, 1-h and 2-h glucose levels and the area under curve of glucose, but also positively related to insulin sensitivity and secretion, as suggested by fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment index of β-cell secretion (HOMA-β) (all P < 0.05). Moreover, IL-6 and leptin levels were positively correlated with HOMA-IR and HOMA-β, and TNF-α levels were positively related to HOMA-IR (all P < 0.05). Except for the relationships between NGF and HOMA-β and TNF-α and HOMA-IR, the other correlations still existed even after adjusting for confounding factors (all P < 0.05).
In addition to the positive associations of IL-6 and leptin with insulin resistance and secretion, NGF was higher in the GDM patients and strongly linked to glucose metabolism, insulin resistance and pancreatic β cell function in Chinese pregnant women in the second trimester.
炎症相关因子在整个孕期均发挥重要作用。本研究旨在探讨中国孕妇中某些炎症细胞因子与妊娠期糖尿病（GDM）之间的关系。
这是一项1:1匹配的病例对照研究，包括200对孕中期受试者和130对孕晚期受试者。采用酶免疫法测定血清神经生长因子（NGF）、白细胞介素-6（IL-6）、瘦素、白细胞介素-8（IL-8）、单核细胞趋化蛋白-1（MCP-1）、肿瘤坏死因子-α（TNF-α）和白细胞介素-1β（IL-1β）水平。分析这些炎症因子与代谢参数之间的关联。
在孕中期，GDM患者的NGF水平高于正常对照组，IL-8水平低于正常对照组（分别为P < 0.001和P = 0.015）。然而，在孕晚期，仅在GDM组观察到较低的瘦素水平（P = 0.031）。此外，在孕中期，NGF水平不仅与空腹、1小时和2小时血糖水平及血糖曲线下面积呈正相关，还与胰岛素敏感性和分泌呈正相关，空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）和β细胞分泌稳态模型评估指数（HOMA-β）表明了这一点（均P < 0.05）。此外，IL-6和瘦素水平与HOMA-IR和HOMA-β呈正相关，TNF-α水平与HOMA-IR呈正相关（均P < 0.05）。除了NGF与HOMA-β以及TNF-α与HOMA-IR之间的关系外，即使在调整混杂因素后，其他相关性仍然存在（均P < 0.05）。
除了IL-6和瘦素与胰岛素抵抗和分泌呈正相关外，GDM患者的NGF水平较高，且在孕中期与中国孕妇的糖代谢、胰岛素抵抗和胰腺β细胞功能密切相关。
