Wang Yunyang, Zhang Xianjuan, Zheng Xu, Song Guanghui, Fang Lina, Wang Yangang, Wang Bin
Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China.
School of Basic Medicine, Qingdao University, Qingdao, China.
PeerJ. 2022 Feb 15;10:e12934. doi: 10.7717/peerj.12934. eCollection 2022.
Infection is an important risk factor for gestational diabetes mellitus (GDM), while infection of human cytomegalovirus (HCMV) with GDM remains unclear and rarely reported. This study aimed to investigate the association of HCMV infection and serum inflammatory factor levels in pregnancy with GDM.
This prospective study included pregnant women who attended at Affiliated Hospital of Qingdao Hospital and Zibo Maternal and Child Health Hospital between December 2018 and August 2020. HCMV specific IgM and serum levels of inflammatory factors, including TNF-α, IL-6, and IL-1β, were analyzed.
A total of 5,316 pregnant women were included (415 with GDM (107 with HCMV+GDM+ and 308 with HCMV-GDM+) and 4901 GDM-free (759 with HCMV+GDM- and 4142 with HCMV-GDM-)). The prevalence of GDM was 7.81%. The rate of activation of HCMV was 16.29%. Specifically, 107 and 759 women in the GDM and control group exhibited HCMV infection, with positive rates of25.78% and 15.48%, respectively ( < 0.01). TNF-α, IL-6, and IL-1β at 24-28 weeks of gestation were significantly higher in women with GDM and HCMV infection than inthe other groups (all < 0.01). Multivariable analysis showed that HCMV positive (OR = 1.851; 95% CI [1.425-2.403]; < 0.001), IL-6 (OR = 1.010; 95% CI [1.002-1.018]; = 0.013), and IL-1β (OR = 1.410; 95% CI [1.348-1.474]; < 0.001) were all significantly correlated with GDM.
This study suggests HCMV infection during pregnancy is an independent risk factor of GDM and could significantly increase its incidence. Further studies are needed to elucidate possible mechanisms underlying associations between HCMV infection and GDM.
感染是妊娠期糖尿病（GDM）的重要危险因素，而人巨细胞病毒（HCMV）感染与GDM的关系尚不清楚且鲜有报道。本研究旨在探讨孕期HCMV感染与血清炎症因子水平与GDM的关系。
这项前瞻性研究纳入了2018年12月至2020年8月期间在青岛大学附属医院和淄博市妇幼保健院就诊的孕妇。分析了HCMV特异性IgM以及包括TNF-α、IL-6和IL-1β在内的炎症因子血清水平。
共纳入5316名孕妇（415例GDM患者（107例HCMV+GDM+和308例HCMV-GDM+）和4901例非GDM患者（759例HCMV+GDM-和4142例HCMV-GDM-））。GDM的患病率为7.81%。HCMV激活率为16.29%。具体而言，GDM组和对照组分别有107例和759例妇女出现HCMV感染，阳性率分别为25.78%和15.48%（P<0.01）。妊娠24-28周时，GDM合并HCMV感染的妇女的TNF-α、IL-6和IL-1β水平显著高于其他组（均P<0.01）。多变量分析显示，HCMV阳性（OR = 1.851；95%CI[1.425-2.403]；P<0.001）、IL-6（OR = 1.010；95%CI[1.002-1.018]；P = 0.013）和IL-1β（OR = 1.410；95%CI[1.348-1.474]；P<0.001）均与GDM显著相关。
本研究表明孕期HCMV感染是GDM的独立危险因素，可显著增加其发病率。需要进一步研究以阐明HCMV感染与GDM之间关联的潜在机制。
