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Decreased Monocyte Count Is Associated With Gestational Diabetes Mellitus Development, Macrosomia, and Inflammation
The Journal of Clinical Endocrinology & Metabolism ( IF 5.8 ) Pub Date : 2021-09-03 , DOI: 10.1210/clinem/dgab657
Xinmei Huang 1 , Bingbing Zha 1 , Manna Zhang 2 , Yue Li 1 , Yueyue Wu 1 , Rui Zhang 1 , Li Sheng 1 , Jiong Xu 1 , Zhiyan Yu 1 , Cuijun Gao 3 , Zaoping Chen 1 , Heyuan Ding 1 , Ling Ma 3 , Yanquan Zhang 3 , Shufei Zang 1 , Tie-Ning Zhang 4, 5, 6 , Jun Liu 1
Affiliation  

Abstract
Context
The immune system plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). Monocytes, the main innate immune cells, are especially important in the maintenance of a normal pregnancy.
Objective
Here, we investigated the potential effect of monocytes in GDM.
Methods
Monocyte count was monitored throughout pregnancy in 214 women with GDM and 926 women without in a case-control and cohort study. Circulating levels of inflammatory cytokines, placenta-derived macrophages, and their products were measured.
Results
Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and was closely associated with glucose level, insulin resistance, and newborn weight. First-trimester monocyte count outperformed that of the second and third trimester as a risk factor and diagnostic predictor of GDM and macrosomia both in the case-control and cohort study. In addition, our cohort study showed that as first-trimester monocyte count decreased, GDM and macrosomia incidence, glucose level, and newborn weight increased in a stepwise manner. Risk of GDM started to decrease rapidly when first-trimester monocyte count exceeded 0.48 × 109/L. Notably, CD206 and interleukin 10 (IL-10) were significantly lower, whereas CD80, CD86, tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6) were higher both in GDM placental tissue and peripheral blood. First-trimester monocyte count was positively related to IL-10 and CD206, but negatively related to CD80, CD86, TNF-α, and IL-6.
Conclusion
Decreased monocyte count throughout pregnancy was closely associated with the development of GDM, macrosomia, and the chronic inflammatory state of GDM. First-trimester monocyte count has great potential as an early diagnostic marker of GDM.


中文翻译:

单核细胞计数减少与妊娠期糖尿病发展、巨大儿和炎症有关

摘要
语境
免疫系统在妊娠期糖尿病 (GDM) 的病理生理学中起核心作用。单核细胞是主要的先天免疫细胞,对于维持正常妊娠尤为重要。
客观的
在这里,我们研究了单核细胞在 GDM 中的潜在影响。
方法
在一项病例对照和队列研究中,对 214 名患有 GDM 的女性和 926 名没有 GDM 的女性在整个妊娠期间监测了单核细胞计数。测量了炎症细胞因子、胎盘衍生巨噬细胞及其产物的循环水平。
结果
在整个妊娠期间,GDM 女性的单核细胞计数显着下降,并且与葡萄糖水平、胰岛素抵抗和新生儿体重密切相关。在病例对照和队列研究中,作为 GDM 和巨大儿的危险因素和诊断预测指标,孕早期单核细胞计数优于孕中期和孕晚期。此外,我们的队列研究表明,随着孕早期单核细胞计数的减少,GDM 和巨大儿的发病率、血糖水平和新生儿体重逐步增加。当孕早期单核细胞计数超过 0.48 × 10 9时,GDM 的风险开始迅速下降/L。值得注意的是,GDM 胎盘组织和外周血中的 CD206 和白细胞介素 10 (IL-10) 显着降低,而 CD80、CD86、肿瘤坏死因子 α (TNF-α) 和白细胞介素 6 (IL-6) 均较高。孕早期单核细胞计数与 IL-10 和 CD206 呈正相关,但与 CD80、CD86、TNF-α 和 IL-6 呈负相关。
结论
整个孕期单核细胞计数减少与 GDM、巨大儿和 GDM 的慢性炎症状态密切相关。孕早期单核细胞计数作为 GDM 的早期诊断标志物具有巨大潜力。
更新日期:2021-09-03
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