Effects of postpartum serum interleukin-34 level on abnormal glucose metabolism outcome and insulin resistance recovery in patients with gestational diabetes mellitus

doi:10.3877/cma.j.issn.1673-5250.2021.05.015

Objective

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.

Methods

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.

Results

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).

Conclusions

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.

Key words: Diabetes, gestational, Postpartum period, Interleukins, Glucose metabolism disorders, Insulin resistance, Puerperant

表1 2组GDM患者一般临床资料、产后糖代谢相关指标及血清IL-34水平比较(±s)

组别	例数	年龄(岁)	分娩孕龄(周)	BMI(kg/m²)		产后FPG水平(mmol/L)	产后OGTT 1 h血糖水平(mmol/L)
组别	例数	年龄(岁)	分娩孕龄(周)	产前	产后	产后FPG水平(mmol/L)	产后OGTT 1 h血糖水平(mmol/L)
糖代谢异常组	38	30.6±3.4	23.0±9.0	28.5±3.8	23.4±3.4	5.2±1.0	11.0±2.3
糖代谢正常组	44	29.9±5.6	26.7±7.6	29.8±3.9	24.1±3.6	4.1±1.0	10.6±2.4
t值		0.671	2.019	1.523	0.901	4.967	0.767
P值		0.504	0.047	0.132	0.370	<0.001	0.445
组别	例数	产后OGTT 2 h血糖水平(mmol/L)	产后FINS水平(mU/L)	产后OGTT 1 h胰岛素水平(mU/L)	产后OGTT 2 h胰岛素水平(mU/L)	产后HOMA-IR值	产后血清IL-34水平(ng/L)
糖代谢异常组	38	10.7±1.2	12.5±2.2	73.7±36.0	86.5±20.4	2.87±0.53	93.9±22.1
糖代谢正常组	44	6.4±1.1	7.9±1.3	89.3±39.8	25.7±9.8	1.42±0.19	62.8±10.3
t值		16.923	11.709	1.849	17.573	16.944	8.349
P值		<0.001	<0.001	0.068	<0.001	<0.001	<0.001

表1 2组GDM患者一般临床资料、产后糖代谢相关指标及血清IL-34水平比较(±s)

组别	例数	年龄(岁)	分娩孕龄(周)	BMI(kg/m²)		产后FPG水平(mmol/L)	产后OGTT 1 h血糖水平(mmol/L)
组别	例数	年龄(岁)	分娩孕龄(周)	产前	产后	产后FPG水平(mmol/L)	产后OGTT 1 h血糖水平(mmol/L)
糖代谢异常组	38	30.6±3.4	23.0±9.0	28.5±3.8	23.4±3.4	5.2±1.0	11.0±2.3
糖代谢正常组	44	29.9±5.6	26.7±7.6	29.8±3.9	24.1±3.6	4.1±1.0	10.6±2.4
t值		0.671	2.019	1.523	0.901	4.967	0.767
P值		0.504	0.047	0.132	0.370	<0.001	0.445
组别	例数	产后OGTT 2 h血糖水平(mmol/L)	产后FINS水平(mU/L)	产后OGTT 1 h胰岛素水平(mU/L)	产后OGTT 2 h胰岛素水平(mU/L)	产后HOMA-IR值	产后血清IL-34水平(ng/L)
糖代谢异常组	38	10.7±1.2	12.5±2.2	73.7±36.0	86.5±20.4	2.87±0.53	93.9±22.1
糖代谢正常组	44	6.4±1.1	7.9±1.3	89.3±39.8	25.7±9.8	1.42±0.19	62.8±10.3
t值		16.923	11.709	1.849	17.573	16.944	8.349
P值		<0.001	<0.001	0.068	<0.001	<0.001	<0.001

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