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炎症因子、糖化血红蛋白及血小板参数在妊娠期糖尿病中的作用

Impact of inflammatory factors, hemoglobin A1c, and platelet parameters in gestational diabetes mellitus.

作者信息

Xiang Lan-Lan, Chen Chen, Wang Qian-Yi, Zhu Yi-Tian, Chen Ya-Jun, Zeng Yu

机构信息

Department of Clinical Laboratory, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 21000, Jiangsu Province, China.

School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, 21000, Jiangsu Province, China.

出版信息

Arch Gynecol Obstet. 2023 Feb;307(2):439-446. doi: 10.1007/s00404-022-06528-x. Epub 2022 Apr 1.

Abstract

PURPOSE

The aim of this study was to evaluate the relationship among inflammatory cytokines including hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6), glycated hemoglobin A1c (HbA1c), and platelet distribution width (PDW) in women with gestational diabetes mellitus (GDM).

METHODS

Data on 191 pregnant women (96 women with GDM; 95 healthy controls) were extracted from routine prenatal examination records in Nanjing, China. Fasting concentrations of hs-CRP, IL-6, HbA1c, blood cell indices, and glucose at 24-28th gestational weeks were determined.

RESULTS

The levels of hs-CRP, IL-6, FPG, PG1h, PG2h, HbA1c, RBC, and PDW significantly were increased (P < 0.05) in GDM group. hs-CRP had a positive correlation with HbA1c and PLT (P < 0.05). The odds ratios of HbA1c and PDW were 7.817 (95% CI 1.921-31.816, P = 0.004) and 1.523 (95% CI 1.158-2.002, P = 0.003), respectively. Furthermore, AUC of the combined diagnosis of GDM including HbA1c, FPG, and PDW reached 0.754, with specificity of 80.0% and sensitivity of 60.4%.

CONCLUSION

Our findings support that elevated levels of hs-CRP, IL-6, HbA1c, and PDW at 24-28th gestational weeks even within the conventional normal range, may be implicated in the pathogenesis of GDM and their evaluation should be part of prenatal care routine.

摘要

目的

本研究旨在评估妊娠糖尿病(GDM)女性中包括超敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)在内的炎性细胞因子、糖化血红蛋白A1c(HbA1c)和血小板分布宽度(PDW)之间的关系。

方法

从中国南京的常规产前检查记录中提取了191名孕妇的数据(96名GDM女性;95名健康对照)。测定了妊娠24 - 28周时hs-CRP、IL-6、HbA1c、血细胞指标和血糖的空腹浓度。

结果

GDM组中hs-CRP、IL-6、空腹血糖(FPG)、餐后1小时血糖(PG1h)、餐后2小时血糖(PG2h)、HbA1c、红细胞(RBC)和PDW水平显著升高(P < 0.05)。hs-CRP与HbA1c和血小板(PLT)呈正相关(P < 0.05)。HbA1c和PDW的比值比分别为7.817(95%可信区间1.921 - 31.816,P = 0.004)和1.523(95%可信区间1.158 - 2.002,P = 0.003)。此外,包括HbA1c、FPG和PDW的GDM联合诊断的曲线下面积(AUC)达到0.754,特异性为80.0%,敏感性为60.4%。

结论

我们的研究结果支持,即使在传统正常范围内,妊娠24 - 28周时hs-CRP、IL-6、HbA1c和PDW水平升高可能与GDM的发病机制有关,对它们的评估应成为产前检查常规的一部分。

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