探讨妊娠期糖尿病(GDM)患者产后血清白细胞介素(IL)-34水平，对其糖代谢异常转归及胰岛素抵抗(IR)恢复的影响。

选择2015年1月至2019年6月，于蚌埠市第一人民医院被诊断为GDM并分娩的82例单胎妊娠产妇为研究对象。根据产后3~6个月的糖代谢异常转归情况，将其分为糖代谢异常组(n＝38)及糖代谢正常组(n＝44)。采用独立样本t检验，对2组患者一般临床资料，产后糖代谢相关指标及血清IL-34水平进行统计学比较；采用Pearson直线相关分析法，对糖代谢异常组GDM患者血清IL-34水平与临床指标的相关性进行分析。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。患者及家属均签署临床研究知情同意书。

①2组GDM患者年龄、产前及产后人体质量指数(BMI)、产后口服葡萄糖耐量试验(OGTT) 1 h血糖及OGTT 1 h胰岛素水平比较，差异均无统计学意义(P>0.05)。②糖代谢异常组GDM患者分娩孕龄小于糖代谢正常组；产后血清空腹血糖(FPG)、OGTT 2 h血糖、空腹胰岛素(FINS)及OGTT 2 h胰岛素水平，以及胰岛素抵抗稳态模型评估(HOMA-IR)值及产后血清IL-34水平，均显著高于糖代谢正常组，并且差异均有统计学意义(P<0.05)。③糖代谢异常组GDM患者血清IL-34水平分别与FPG、OGTT 2 h血糖、FINS、OGTT 2 h胰岛素水平，以及HOMA-IR值均呈正相关关系(r＝0.429、0.449、0.723、0.712、0.613，P<0.05)；而与分娩孕龄无相关性(r＝—0.513、P＝0.079)。

GDM患者产后容易发生糖代谢异常；其血清IL-34水平升高，可能导致产后糖代谢异常及IR。

To explore effects of postpartum serum interleukin (IL)-34 levels in patients with gestational diabetes mellitus (GDM) on abnormal glucose metabolism outcome and insulin resistance (IR) recovery.

From January 2015 to June 2019, a total of 82 singleton pregnant women diagnosed as GDM and delivered in Bengbu first people′s Hospital were selected as research objects. They were divided into abnormal glucose metabolism group (n=38) and normal glucose metabolism group (n=44) according to abnormal glucose metabolism outcome at 3-6 months postpartum. Independent-samples t test was used to compare the general clinical data, postpartum glucose metabolism related indexes and serum IL-34 level between two groups; Pearson linear correlation analysis was used to analyze the correlation between serum IL-34 level and clinical indexes of GDM patients in abnormal glucose metabolism group. The procedure followed in this study was consistent with the World Medical Association Declaration of Helsinki revised in 2013. Patients and their families signed the informed consent forms for clinical research.

①There were no significant differences between two groups of GDM patients in age, prenatal and postpartum body mass index (BMI), postpartum oral glucose tolerance test (OGTT) 1 h blood glucose and OGTT 1 h insulin levels (P>0.05). ②The gestational age of GDM patients in abnormal glucose metabolism group was less than that in normal glucose metabolism group; postpartum serum fasting blood glucose (FPG), OGTT 2 h blood glucose, fasting insulin (FINS) and OGTT 2 h insulin levels, and insulin resistance homeostasis model assessment (HOMA-IR) value and postpartum serum IL-34 level of GDM patients in abnormal glucose metabolism group were all significantly higher than those in normal glucose metabolism group, and the differences were statistically significant (P<0.05). ③The serum IL-34 level of GDM patients in abnormal glucose metabolism group were positively correlated with FPG level, OGTT 2 h blood glucose level, FINS level, OGTT 2 h insulin level and HOMA-IR value (r=0.429, 0.449, 0.723, 0.712, 0.613; P<0.05), respectively. There was no correlation between IL-34 level and gestational age of delivery (r=—0.513, P=0.079).

After childbirth, GDM patients who higher in serum IL-34 level will be more at risk of postpartum abnormal glucose metabolism and IR than those lower.