INTRODUCTION. The aim of the article is to asses metabolic changes in pregnant women with gestational diabetes and compare to healthy women as well as to determine whether GDM is characterized by relative changes in C-reactive protein (CRP) level.
MATERIAL AND METHODS. We performed a crosssectional study that included 335 pregnant women, all of the Caucasian race. They underwent oral glucose tolerance test (OGTT) in the late second or early third trimester. Based on OGTT, the participants were stratified into GDM group (n = 260) and normal glucose tolerance (NGT) group (n = 75). Insulin, C-peptide, HbA_1C and CRP level were evaluated.
RESULTS. Those groups did not differ in age and body weight before and after pregnancy. We did not find any differences between GDM and NGT groups in respect to the level of HbA_1C (respectively: 5.04 ± ± 0.5 vs. 4.96 ± 0.4%; p = 0.2) and C-peptide level (respectively: 2.5 ± 1.4 vs. 2.4 ± 1.2 ng/ml; p = 0.5). We did not find statistical differences between CRP level in both groups, however we observed a slightly higher level of CRP in GDM group (respectively: 5.47 ± 7.1 vs. 4.0 ± 3.1 mg/l; p = 0.2). There were differences in frequency of overweight and obesity favouring GDM group as compared to NGT (p = 0.03). We performed additional analysis based on prepregnancy body mass index (BMI). Participants were stratified into groups with normal body weight (1), overweight (2) and obesity (3). CRP level was statistically elevated in obese participants as compared to lean ones in both GDM (respectively: 4.7 ± 8.1 vs. 5.9 ± ± 6.1 mg/l; p = 0.4 and 4.7 ± 8.1 vs. 7.7 ± 5.6 mg/l; p = 0.04) and NGT groups (respectively: 3.2 ± 2.8 vs. 4.2 ± 2.4 mg/l; p = 0.3 and 3.2 ± 2.8 vs. 5.4 ± ± 2.1 mg/l; p = 0.04).
CONCLUSIONS. Our data suggest that inflammatory status is more associated with obesity than diabetes during pregnancy and obesity my play a key role in mediating insulin resistance in gestational diabetes.