血清高敏C反应蛋白与妊娠糖尿病的相关性研究

回园敕 向红丁 平凡 李伟 张化冰 许岭翎 黎明 聂敏 张丽红

【摘要】 目的 探讨血清高敏C反应蛋白(hsC-RP)水平与妊娠糖尿病(GDM)的相关性。 方法 在妊娠中晚期检测孕妇的血清hsC-RP水平。将患GDM的306例孕妇作为病例组(GDM组)，糖耐量正常的347名孕妇作为对照组(Con组)，比较两组的血清hsC-RP水平，再按hsC-RP水平四分位，将研究对象分为4组，进行Logistic回归分析。 结果 GDM组的血清hsC-RP中位数水平明显高于Con组(3.01 mg/L vs 2.15 mg/L,P<0.01)。根据hsC-RP水平四分位的 结果 ，将研究对象分为4组，第1组hsC-RP <1.41 mg/L，第2组hsC-RP 1.41～2.41 mg/L，第3组hsC-RP 2.42～4.60 mg/L，第4组hsC-RP ≥4.61 mg/L，相应的GDM的检出率分别为36.81%、42.68%、48.47%、59.51%。调整年龄、孕次、孕前BMI、SBP、DBP及糖尿病家族史等因素，行Logistic回归分析发现，hsC-RP是GDM的独立危险因素(OR值为1.27,95%CI为1.08～1.49, P<0.01)。 结论 GDM患者妊娠中晚期hsC-RP水平明显升高，慢性炎症可能参与了GDM的发生。

doi:10.3969/j.issn.1006-6187.2011.06.012

Association of highsensitive C-reactive protein with gestational diabetes mellitus

HUI Yuan-chi, XIANG Hong-ding, PING Fan, et al.

Department of Endocrinology, Fu Wai Hospital, Beijing 100037, China

Corresponding author: XIANG Hong-ding, E-mail:xinghd@vip.sohu.net

【Abstract】 Objective To investigate the relevance between high sensitive C-reactive protein(hsC-RP) and gestational diabetes mellitus (GDM). Methods In the late second or early third trimester,serum levels of hsC-RP were measured.

This study included randomly the 306 women who developed GDM and 347 women who remained euglycemic throughout pregnancy. Median hsC-RP levels were compared using Wilcoxon’s rank-sum test. Logistic regression was used to compute unadjusted and multivariable-adjusted odds ratios for developing GDM among hsC-RP quartiles. Results Median hsC-RP levels were significantly increased in GDM subjects as compared with control pregnant women (3.01 mg/L vs 2.15 mg/L,P<0.01). The serum hsC-RP values for the first to the fourth quartile were 0.15～1.40 mg/L,1.41～2.41 mg/L,2.42～4.60 mg/L,4.61～10.00 mg/L,respectively.Detection rate of GDM for the respective quartiles were 36.81%，42.68%，48.47%，59.51%。After adjusting for age, parity, and family history of diabetes,an independent contribution of hsC-RP to risk of GDM could be confirmed(odds ratio=1.27,95% confidence interval=1.08～1.49,P<0.01). Conclusions In GDM women, there is evidence of increased serum levels of hsC-RP in the late second or early third trimester. Systemic inflammation may be associated with the development of GDM.

【Key words】Gestational diabetes mellitus; High sensitive C reactive protein;Inflammation