妊娠期糖尿病与CRP、IGF-1及IGFBP-1相关性研究  

Relationship between changes of C-reactive protein and insulin like growth factor-1 and insulin like growth factor binding protein-1 in maternal serum and pathogenesis of gestational diabetes mellitus

作　　者：毛邱娴[1] 尹春艳[1] 

机构地区：[1]广东省第二人民医院产科,广州赤岗510317

出　　处：《中国优生与遗传杂志》2009年第5期36-37,41,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨C反应蛋白(CRP)、胰岛素样生长因子1(IGF-1)与胰岛素样生长因子结合蛋白l(IGFBP-1)在妊娠期糖尿病(GDM)发病中的作用。方法采用免疫透射比浊法和酶联免疫吸附法(ELISA)检测孕24～28周GDM孕妇18例(观察组)和29例正常孕妇(对照组)外周血CRP、IGF-1及IGFBP-1水平,并分析CPR与体重指数、IGF-1与IGFBP-1的相关性。结果(1)两组体重指数(BMI)比较:GDM组(26.01±3.54)kg,较正常组(23.31±2.13)kg高,差异有统计学意义(P<0.01);(2)血清CRP水平:GDM组(8.65±5.38)mg/dl,较正常组(5.83±3.26)mg/dl为高,但差异无统计学意义(P>0.05);(3)血清IGF-1水平:GDM组(89.16±41.32)ng/ml,正常组(148.95±53.90)ng/ml,两组比较差异有统计学意义(P<0.01);(4)血清IGFBP-1水平:GDM组(59.43±10.97)ng/ml较正常组(52.33±9.68)ng/ml高,两组比较差异有统计学意义(P<0.01);(5)相关性:血清CRP与体重指数成正相关(r=0.849,P<0.01);血清CRP水平与体重指数成正相关,IGF-1与IGFBP-1成负相关(r=-0.33755,P<0.05)。结论CRP对GDM风险的独立影响不能被证实,但母体血清CRP水平与妊娠期的BMI显著相关,推论肥胖介导的炎症反应导致胰岛素抵抗和糖代谢失调;孕妇外周血IGF-1、IGFBP-1与GDM的发生相关。Objective： To study the role of C - reactive protein （ CRP）, insulin like growth factor - 1 （ IGF - 1 ） and insulin like growth factor binding protein - 1 （ IGFBP - 1 ） in the pathogenesis of gestational diabetes mellitus （GDM）. Methods ： The levels of CRP, IGF-1 and IGFBP- 1 in maternal blood were detected from 18 patients with （GDM group） and 29 normal pregnant women （control group） which were 24 to 28 weeks gestation by particle enhanced immunoturbidimetic assay and enzyme linked immunosorbent assay （ELISA） . Results： （1） Serum level of CRP （8.65 ±5.38） mg/dl, in GDM group was higher than that in control group （5.83 ±3.26） mg/dl. But there was not statistically significant. （2） serum IGF - 1 from GDM group （89. 16 ±41.32） ng/ml was significantly lower than that in control group （ 148.95 ± 53.90） ng/ml, （ P 〈 0. 01 ）. （ 3 ） serum IGFBP - 1 from GDM group （59.43 ± 10.9） ng/ml was significantly lower than that in control group （52. 33 ±9. 68） ng/ml, （ P 〈0. 01 ）. （4） The levels of CRP in serum had a significant positive relationship with that of body mass index in both group （ r = 0. 849, P 〈 0. 01 ） ; The levels of IGF - 1 in serum had a significant negative relationship with IGFBP - 1 in both group （ r = - 0. 33755, P 〈 0. 05 ） . Conclusion： The changes of levels of IGF - 1 and IGFBP - 1 are related to the occurrence and development of GDM ; CRP level are related to gravida＇s BMI, deduced inflammatory reaction mediated by obesity induce insulin resistance and glycometabolism disorder, although it can＇ t confirm that systemic inflammation is associated with an increased risk of GDM.

关 键 词：妊娠期糖尿病 C反应蛋白 胰岛素样生长因子-1 胰岛素样生长因子结合蛋白质-1 

分 类 号：R714.25[医药卫生—妇产科学]