The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

The relationship between maternal serum Interleukin-6 and CRP levels at first trimester of pregnancy and gestational diabetes occurrence

Document Type : Original Article

Authors
Fazeleh Hezareh 1
Lida Moghaddam-Banaem 2
Shadab Shahali 3
1 PhD student of Reproductive Health , Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
2 6. Associate Professor, Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
3 Assistant Professor, Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
10.22038/ijogi.2021.18572
Abstract
Introduction: Diabetes is the most common medical complication of pregnancy. Identifying the new risk factor can help to early diagnosis of the disorder. CRP and Interleukin-6 are two inflammatory markers which can anticipate some pregnancy adverse complications. This study was performed with aim to assess the relationships between maternal serum CRP and Interleukin-6 (IL-6) at first trimester of pregnancy and gestational diabetes Mellitus (GDM) occurrence.
Methods: This descriptive-analytical cross-sectional study was performed in 2015-2016 on 500 pregnant women with gestational age < 14 weeks in Nilou laborator, Tehran. Serum levels of CRP, IL-6, fasting blood sugar (FBS) and lipid profile were measured. GDM screening was performed in 24-28 weeks of gestation. Data were analyzed by SPSS statistical software (version 21) and Kolmogorov-Smirnov, Chi-square, Mann-Whitney tests and Logistic regression model. P<0.05 was considered statistically significant.
Results: GDM was found in 78 women (15.6%). Median CRP levels in GDM and non-GDM groups (4.8 vs. 5.22 mg/ml) (P=0.089) and median IL-6 (1.45 vs. 1.5 pg/ml) (P=0.574) was different, but the difference was not statistically significant. After adjusting the confounding variables in the logistic regression model, there were no statistically significant relations between serum level of CRP (OR=1.01, CI95%=0.96-1.07) (P=0.50) and IL-6 (OR=1.01, CI95%=0.89-1.46) (P=0.88) with GDM occurrence.
Conclusion: CRP and IL-6 levels are not significantly associated with the occurrence of GDM.
Keywords
CRP
Gestational Diabetes
IL-6
Pregnancy
  1. Cunningham FG, Kenneth J, Bloom SL, Spong CY, Dash JS, Hoffman BL, et al. Williams obstetrics. 24nd ed. New York: McGraw-Hill; 2014.
  2. Mishra S, Rao CR, Shetty A. Trends in the diagnosis of gestational diabetes mellitus. Scientifica 2016; 2016 :5489015.
  3. Sayehmiri F, Bakhtiyari S, Darvishi P, Sayehmiri K. Prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran J Obstet Gynecol Infertil 2013; 15(40):16-23.
  4. Mpondo BC, Ernest A, Dee HE. Gestational diabetes mellitus: challenges in diagnosis and management. Journal of Diabetes & Metabolic Disorders 2015; 14(1):1-7.
  5. Baraban E, McCoy L, Simon P. Peer Reviewed: Increasing Prevalence of Gestational Diabetes and Pregnancy-Related Hypertension in Los Angeles County, California, 1991–2003. Preventing chronic disease 2008; 5(3).
  6. Li X, Lu X. Study on correlation between C-reactive protein and gestational diabetes mellitus. Journal of Nanjing Medical University 2007; 21(6):382-5.
  7. Wolf M, Sandler L, Hsu K, Vossen-Smirnakis K, Ecker JL, Thadhani R. First-trimester C-reactive protein and subsequent gestational diabetes. Diabetes care 2003; 26(3):819-24.
  8. Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes care 2004; 27(3):813-23.
  9. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. Jama 2001; 286(3):327-34.
  10. Black S, Kushner I, Samols D. C-reactive protein. Journal of Biological Chemistry 2004; 279(47):48487-90.
  11. Maggio M, Guralnik JM, Longo DL, Ferrucci L. Interleukin-6 in aging and chronic disease: a magnificent pathway. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2006; 61(6):575-84.
  12. Kern PA, Ranganathan S, Li C, Wood L, Ranganathan G. Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance. American Journal of Physiology-Endocrinology And Metabolism 2001; 280(5):E745-51.
  13. Gabay C. Interleukin-6 and chronic inflammation. Arthritis research & therapy 2006; 8(2):1-6.
  14. Kariman N, Ahi Z, Zahedi S, Majd A. Relationship between maternal serum C-reactive protein concentration and gestational diabetes mellitus. Journal Of Diabetes 2013; 5.
  15. Bossick AS, Peters RM, Burmeister C, Kakumanu N, Shill JE, Cassidy-Bushrow AE. Antenatal inflammation and gestational diabetes mellitus risk among pregnant African-American women. Journal of reproductive immunology 2016; 115:1-5.
  16. Kuzmicki M, Telejko B, Szamatowicz J, Zonenberg A, Nikolajuk A, Kretowski A, et al. High resistin and interleukin-6 levels are associated with gestational diabetes mellitus. Gynecological endocrinology 2009; 25(4):258-63.
  17. Hassiakos D, Eleftheriades M, Papastefanou I, Lambrinoudaki I, Kappou D, Lavranos D, et al. Increased maternal serum interleukin-6 concentrations at 11 to 14 weeks of gestation in low risk pregnancies complicated with gestational diabetes mellitus: development of a prediction model. Hormone and Metabolic Research 2016; 48(01):35-41.
  18. D'Anna R, Baviera G, De Vivo A, Facciolà G, Di Benedetto A, Corrado F. C-reactive protein as an early predictor of gestational diabetes mellitus. The Journal of reproductive medicine 2006; 51(1):55-8.
  19. Berggren EK, Roeder HA, Boggess KA, Moss K, Offenbacher S, Campbell E, Grotegut CA. First-trimester maternal serum C-reactive protein as a predictor of third-trimester impaired glucose tolerance. Reproductive sciences 2015; 22(1):90-3.
  20. Lain KY, Daftary AR, Ness RB, Roberts JM. First trimester adipocytokine concentrations and risk of developing gestational diabetes later in pregnancy. Clinical endocrinology 2008; 69(3):407-11.
  21. Gueuvoghlanian‐Silva BY, Torloni MR, Mattar R, de Oliveira LS, Scomparini FB, Nakamura MU, et al. Profile of inflammatory mediators in gestational diabetes mellitus: phenotype and genotype. American Journal of Reproductive Immunology 2012; 67(3):241-50.
  22. Lopez-Tinoco C, Roca M, Fernandez-Deudero A, García-Valero A, Bugatto F, Aguilar-Diosdado M, et al. Cytokine profile, metabolic syndrome and cardiovascular disease risk in women with late-onset gestational diabetes mellitus. Cytokine 2012; 58(1):14-9.
  23. Siddiqui S, Waghdhare S, Panda M, Dubey S, Jha S. Association of IL-6 and CRP levels with gestational diabetes mellitus. Diabetes 2018; 67(1):2417-PUB
  24. Bastard JP, Maachi M, Van Nhieu JT, Jardel C, Bruckert E, Grimaldi A, et al. Adipose tissue IL-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. The Journal of Clinical Endocrinology & Metabolism 2002; 87(5):2084-9.
  25. Müller S, Martin S, Koenig W, Hanifi-Moghaddam P, Rathmann W, Haastert B, et al. Impaired glucose tolerance is associated with increased serum concentrations of interleukin 6 and co-regulated acute-phase proteins but not TNF-α or its receptors. Diabetologia 2002; 45(6):805-12.
  26. Atègbo JM, Grissa O, Yessoufou A, Hichami A, Dramane KL, Moutairou K, et al. Modulation of adipokines and cytokines in gestational diabetes and macrosomia. The Journal of Clinical Endocrinology & Metabolism 2006; 91(10):4137-43.
  27. Yu F, Xue YM, Li CZ, Shen J, Gao F, Yu YH, et al. Association of serum interleukin-6 and high-sensitivity C-reactive protein levels with insulin resistance in gestational diabetes mellitus. Nan fang yi ke da xue xue bao. Journal of Southern Medical University 2007; 27(6):799-801.
  28. Morisset AS, Dubé MC, Cote JA, Robitaille J, Weisnagel SJ, Tchernof A. Circulating interleukin‐6 concentrations during and after gestational diabetes mellitus. Acta obstetricia et gynecologica Scandinavica 2011; 90(5):524-30.
  29. Kianpour M, Saadatmand F, Nematbakhsh M, Fahami F. Relationship between c-reactive protein and screening test results of gestational diabetes in pregnant women referred to health centers in Isfahan in 2013–2014. Iranian journal of nursing and midwifery research 2019; 24(5):360-4.
  30. Naser W, Adam I, Rayis DA, Ahmed MA, Hamdan HZ. Serum magnesium and high-sensitivity C-reactive protein as a predictor for gestational diabetes mellitus in Sudanese pregnant women. BMC pregnancy and childbirth 2019; 19(1):1-5.
  31. Leipold H, Worda C, Gruber CJ, Prikoszovich T, Wagner O, Kautzky‐Willer A. Gestational diabetes mellitus is associated with increased C‐reactive protein concentrations in the third but not second trimester. European journal of clinical investigation 2005; 35(12):752-7.
  32. Retnakaran R, Hanley AJ, Raif N, Connelly PW, Sermer M, Zinman B. C-reactive protein and gestational diabetes: the central role of maternal obesity. The Journal of Clinical Endocrinology & Metabolism 2003; 88(8):3507-12.
  33. Balletshofer BM, Rittig K, Enderle MD, Volk A, Maerker E, Jacob S, et al. Endothelial dysfunction is detectable in young normotensive first-degree relatives of subjects with type 2 diabetes in association with insulin resistance. Circulation 2000; 101(15):1780-4.
  34. Hu FB, Meigs JB, Li TY, Rifai N, Manson JE. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 2004; 53(3):693-700.
  35. Ozgu-Erdinc AS, Yilmaz S, Yeral MI, Seckin KD, Erkaya S, Danisman AN. Prediction of gestational diabetes mellitus in the first trimester: comparison of C-reactive protein, fasting plasma glucose, insulin and insulin sensitivity indices. J Matern Fetal Neonatal Med 2015; 28(16):1957-62.
  36. Alamolhoda SH, Yazdkhasti M, Namdari M, Zakariayi SJ, Mirabi P. Association between C-reactive protein and gestational diabetes: a prospective study. Journal of Obstetrics and Gynaecology 2020; 40(3):349-53.
  37. Farghaly TA, Helmy NA, Abbas AM, Ahmed AG. C-reactive protein as a screening test for gestational diabetes mellitus in first-trimester of pregnancy: a prospective cohort study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2018; 7(12):4798-4803.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 24, Issue 5
July 2021
Pages 59-68