Clinical value of serum chemokines in pregnant women with gestational diabetes mellitus

doi:10.3877/cma.j.issn.1673-5250.2023.03.017

Objective

To explore the relationship between levels of serum chemokines interleukin (IL) -8, interferon-inducible protein (IP) -10, monocyte chemotactic protein (MCP) -1 and the occurrence and development of gestational diabetes mellitus (GDM).

Methods

From July 2020 to July 2021, a total of 20 singleton pregnant women diagnosed as GDM in Leshan Maternal and Child Health Hospital were enrolled into GDM group. Meanwhile, other 22 normal pregnant women who underwent prenatal examination in our hospital during same period were enrolled into control group by random number table method. Venous blood was collected from pregnant women in both groups at the 8-12 gestational weeks and 24-28 gestational weeks, and serum levels of IL-8, IP-10 and MCP-1 were detected, and 75 g oral glucose tolerance test (OGTT) was performed at 24-28 gestational weeks. Independent sample t test, Mann-Whitney U test and Wilcoxon signed rank sum test were used to statistically analyze results of the above laboratory tests between two groups. Spearman rank correlation analysis was used to analyze the correlation between serum IL-8 level and glucose concentration of 1, 2 h 75 g OGTT of GDM patients during second trimester. Written informed consent was obtained from all research participants and this study was approved by institutional review board of Leshan Maternal and Child Health Hospital (2021-01-01).

Results

①The age, pre-pregnancy body mass index (BMI) and pre-pregnancy abdominal circumference of pregnant women in GDM group were greater than those in control group, while the gestational age at delivery of pregnant women in GDM group was smaller than that of control group, and all differences were statistically significant (P<0.05). ② The fasting blood glucose and 1 and 2 h 75 g OGTT post-glucose concentrations of pregnant women in GDM group were (5.1±0.8) mmol/L, (9.4±2.2) mmol/L and (9.2±1.9) mmol/L, respectively, which were higher than (4.4±0.3) mmol/L, (7.4±1.3) mmol/L and (6.8±0.9) mmol/L in control group. The differences were statistically significant (t=3.80, 3.67, 5.14, P=0.001, 0.001, <0.001). ③ There were no statistically significant differences in terms of the levels of serum IL-8, IP-10 and MCP-1 during first trimester, and serum IP-10 and MCP-1 levels during second trimester between two groups (P>0.05). However, serum IL-8 level in GDM group was significantly higher than that in control group [37.4 pg/mL (22.1 pg/mL, 117.5 pg/mL) vs 11.1 pg/mL (4.4 pg/mL, 21.9 pg/mL)], with a statistically significant difference (Z=-2.98, P=0.003). The serum IL-8 level of GDM group during first and second trimester gradually increased with the increase of gestational age, and the difference was statistically significant (Z=-2.22, P=0.001). ④The serum IL-8 level in second trimester was positively correlated with the concentration of 2 h after 75 g OGTT administration (r=0.37, P=0.026).

Conclusions

Serum IL-8 may play an important role in the occurrence and development of GDM, while serum IP-10 and MCP-1 levels during first and second trimester are not related to the occurrence of GDM.

Key words: Diabetes, gestational, Interleukin-8, Interferon-inducible protein-10, Monocyte chemotactic protein-1, Blood glucose, Glucose tolerance test, Pregnant women

表1 2组孕妇一般临床资料比较

组别	例数	分娩年龄(岁，±s)	孕前BMI(kg/m²，±s)	孕前腹围(cm，±s)	分娩孕龄(周，±s)	新生儿出生体重(g，±s)	剖宫产[例数(%)]	初产妇[例数(%)]
GDM组	20	30.1±4.7	22.8±2.7	85.7±6.8	38.8±1.4	3 296.3±328.3	13(65.0)	5(25.0)
对照组	22	26.6±4.7	21.1±2.7	79.7±6.4	39.6±0.7	3 291.1±367.9	9(40.9)	8(36.4)
统计值		t＝2.37	t＝2.04	t＝2.96	t＝－2.27	t＝0.05	χ²＝2.44	χ²＝0.63
P值		0.023	0.048	0.005	0.029	0.962	0.118	0.426

表1 2组孕妇一般临床资料比较

组别	例数	分娩年龄(岁，±s)	孕前BMI(kg/m²，±s)	孕前腹围(cm，±s)	分娩孕龄(周，±s)	新生儿出生体重(g，±s)	剖宫产[例数(%)]	初产妇[例数(%)]
GDM组	20	30.1±4.7	22.8±2.7	85.7±6.8	38.8±1.4	3 296.3±328.3	13(65.0)	5(25.0)
对照组	22	26.6±4.7	21.1±2.7	79.7±6.4	39.6±0.7	3 291.1±367.9	9(40.9)	8(36.4)
统计值		t＝2.37	t＝2.04	t＝2.96	t＝－2.27	t＝0.05	χ²＝2.44	χ²＝0.63
P值		0.023	0.048	0.005	0.029	0.962	0.118	0.426

表2 2组孕妇空腹血糖及1、2 h 75g OGTT结果比较(mmol/L，±s)

组别	例数	空腹	1 h OGTT	2 h OGTT
GDM组	20	5.1±0.8	9.4±2.2	9.2±1.9
对照组	22	4.4±0.3	7.4±1.3	6.8±0.9
t值		3.80	3.67	5.14
P值		0.001	0.001	<0.001

表2 2组孕妇空腹血糖及1、2 h 75g OGTT结果比较(mmol/L，±s)

组别	例数	空腹	1 h OGTT	2 h OGTT
GDM组	20	5.1±0.8	9.4±2.2	9.2±1.9
对照组	22	4.4±0.3	7.4±1.3	6.8±0.9
t值		3.80	3.67	5.14
P值		0.001	0.001	<0.001

表3 2组孕妇早、中孕期血清IL-8、IP-10和MCP-1水平组内及组间比较(pg/mL)

组别	例数	早孕期			中孕期
组别	例数	IL-8[M(Q₁，Q₃)]	IP-10(±s)	MCP-1(±s)	IL-8[M(Q₁，Q₃)]	IP-10(±s)	MCP-1(±s)
GDM组	20	17.8 (8.7, 27.0)	37.6±23.7	27.4±15.1	37.4(22.1, 117.5)^A	42.0±24.9	20.9 (8.0, 46.9)
对照组	22	15.8 (13.0, 19.3)	41.3±18.9	28.5±14.0	11.1(4.4, 21.9)	35.3±19.6	20.6 (17.9, 30.8)
统计值		Z＝－0.34	t＝－0.56	t＝－0.24	Z＝－2.98	t＝0.93	t＝－0.08
P值		0.736	0.578	0.815	0.003	0.360	0.937

表3 2组孕妇早、中孕期血清IL-8、IP-10和MCP-1水平组内及组间比较(pg/mL)

组别	例数	早孕期			中孕期
组别	例数	IL-8[M(Q₁，Q₃)]	IP-10(±s)	MCP-1(±s)	IL-8[M(Q₁，Q₃)]	IP-10(±s)	MCP-1(±s)
GDM组	20	17.8 (8.7, 27.0)	37.6±23.7	27.4±15.1	37.4(22.1, 117.5)^A	42.0±24.9	20.9 (8.0, 46.9)
对照组	22	15.8 (13.0, 19.3)	41.3±18.9	28.5±14.0	11.1(4.4, 21.9)	35.3±19.6	20.6 (17.9, 30.8)
统计值		Z＝－0.34	t＝－0.56	t＝－0.24	Z＝－2.98	t＝0.93	t＝－0.08
P值		0.736	0.578	0.815	0.003	0.360	0.937

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