[Maternal serum tumor necrosis factor-alpha concentration and correlation with insulin resistance in gestational diabetes].
OBJECTIVE
To investigate serum concentration of tumor necrosis factor (TNF)-alpha and its correlation with insulin resistance in pregnant women with gestational diabetes mellitus (GDM).


METHODS
Enzyme-linked immunosorbent assay was used to measure the fasting serum TNF-alpha levels of 42 women with GDM (28 approximately 39 gestational weeks), and 40 cases of normal pregnant women in the third trimester. Fasting plasma glucose, insulin, C-peptide and glycosylated hemoglobin (HbA1c) were also measured at the same time. Insulin sensitive index (ISI) was calculated.


RESULTS
(1) Significantly elevated serum TNF-alpha was found in the women with GDM (5.2 +/- 1.6) ng/L as compared with the healthy pregnant women in third trimester (4.5 +/- 0.5) ng/L (P < 0.01); ISI between the two groups was significantly different, (-4.3 +/- 0.5) and (...3.8 +/- 0.3) (P < 0.01). (2) fasting plasma glucose, insulin, C-peptide, HbA1c in GDM group were (5.5 +/- 0.7) mmol/L, (13.4 +/- 3.8) mU/L, (1.6 +/- 0.4) nmol/L, (5.6 +/- 0.5)%, being significantly higher than those in the normal pregnant women (P < 0.01 or P < 0.05). (3) Significant negative linear correlation was revealed between TNF-alpha and ISI (r = -0.703, P < 0.01), and positive linear correlations between TNF-alpha and plasma glucose, C-peptide, and HbA1c were found (r = 0.512, 0.629, 0.386); but no correlation between TNF-alpha and insulin was found in GDM group. In normal group the correlation between ISI and TNF-alpha was also found (r = -0.390, P < 0.05), but less significant than that in the GDM group.


CONCLUSIONS
Fasting plasma TNF-alpha levels in pregnant women with GDM is significantly higher than in normal pregnant women. A negative relationship between TNF-alpha and insulin sensitivity index is found in GDM, suggesting increased TNF-alpha may contribute to insulin resistance in pregnant women with gestational diabetes.
Wang
Sheng-Lan
SL
Department of Obstetrics, Qingdao Municipal Hospital, Qingdao 266003, China.
Liu
Pei-Qiu
PQ
Ding
Yu
Y
Peng
Wei
W
Qu
Xin
X
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000096:biosynthesis; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D011247:Pregnancy; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin; D014409:Tumor Necrosis Factor-alpha