Study Of Inflammatory Cytokines In Zhe Etiopathology Of Gestational Diabetes Mellitus

Background: Gestational diabetes mellitus(GDM) is a seriousgestational complication,which happen in zhe terminal period of gestation.It makes zhe mortality and morbidity of fetus and pregnant women increase,so it is given importance in zhe perinatal field.However,zhe etiopathologyis still unknown.Recentanly,the role of inflammation in type2 diabetes hasbeen focused on .There is some relationaship between GDM andinflammation cytokines:c-reactive protein (CRP),tumor necrosis factor-α(TNF-α).Type 2 diabetes is not only a diseases which important symptomis herpyglucose ,but also a inflammatory diseases.GDM is zhe early peroidin zhe natural course of diabetes ,whether zhe inflammatory cytokines takepart in zhe etiopathology of GDM is unkown . Objective: To investigate the role of CRP and TNF- α in zheetiopathology of GDM and the relationship between inflammotory cykinesand insulin resistance. Methods: The blood samples were colleced form 21 gestationaldiabetes mellitus,25 normal glucose tolerance (NGT) and 20 impairedglucose tolerance (IGT). Fasting serum c-reactive protein,TNF-αandglucose,insulin during 75g oral glucose tolerance test(OGTT) at 0 ,1,2,3h were measured by immunologic turbidimelry and radioimmunoassay.Insulin secretion was assessed by zhe homeostasis β -cell functionindex(HOMA-HBCI),Insuin resistance by the homeostasis model insulinresistance index (HOMA-IR).The differences in HOMA-IR ,HOMA-HBCI,CRP and TNF-αbetween theer groups were compared andzhe relationship between fasting CRP,TNF-αand insulin insistance wereanalysed. Results: (1) HOMA-IR was higher in GDM groups(0.59±0.054) thanin IGT groups(0.33±0.0499) and NGT groups(0.24±0.052),there wassignificant difference(P<0.01) between GDM and IGT,GDM and NGT,butthere was no significant difference between IGT and NGT groups.(2)HOMA-HBCI was lower in GDM groups(2.09±0.59)than NGT groups(2.18±0.62) and IGT groups(2.40±0.66).There was significant difference(P<0.05) between GDM and IGT,GDM and NGT.(3)Serum CRP werehigher in GDM(5.43±0.41 mg/l) than IGT groups (3.11±0.19mg/l) ,NGTgroups (3.08±0.19 mg/l).There was significant difference (P<0.01) betweenGDM and IGT ,GDM and NGT . Serum TNF-αwere higher in GDM(6.26±0.24 ng/ml) than IGT groups (4.79 ±0.88 ng/ml) , NGT groups(4.19±0.11 ng/ml).There was significant difference (P<0.01) between GDMand IGT ,GDM and NGT .(4)There was posistive correlation betweenserum concentrations of CRP ,TNF-αand HOMA-IR (r=0.324,P<0.05;r=0.401,P<0.01). Conclusion: (1)There is serious insulin resistance and insulin secretion decrease,which induce GDM together. (2)There is positive correlation between inflammation cytokines:CRP,TNF-αand insulin resistance ,inflammation cytokines may play rolein zhe etiopathology of gestational diabetes mellitus.