The Association Between Pregnancy Serum TNF-α Level and Postpartum Insulin Resistance in Pregnant Women With Gestational Diabetes Mellitus

Abstract

Insulin resistance in gestational diabetes increases maternal and fetal complications. Tumor necrosis factor-alpha (TNF-α) is an inflammatory factor associated with insulin resistance. The aim of this study was to determine the association between pregnancy serum TNF-α level and postpartum insulin resistance in patients with gestational diabetes mellitus. 50 pregnant women, including 25 cases of gestational diabetes and 25 healthy pregnant women, were evaluated. First, during the third trimester of pregnancy, serum TNF-α level of all cases were measured. Two months after delivery, based on the obtained results from insulin levels and a 2-hour glucose tolerance test, HOMA-IR and HOMA-B were calculated, and the association between serum TNF-α level and insulin resistance was determined. Data were analyzed using independent t-test, Mann-Whitney, and chi-square test in SPSS software. The mean serum level of TNF-α in women with gestational diabetes mellitus was higher than healthy subjects, but there was no significant difference between the two groups. The serum level of insulin, HOMA-IR and HOMA-B indices in women with gestational diabetes mellitus were higher than healthy subjects, with a significant difference in all of the measures between two groups (P=0.0001). There was no significant correlation between TNF-α and HOMAIR levels in insulin-resistant mothers two months after delivery (r=−0.33). Also, no significant correlation was detected between pregnancy TNF-α levels and HOMA-B index. Despite the higher serum levels of insulin, HOMA-IR, and HOMA-B in the diabetic group, the serum TNF-α level did not show any correlation with insulin resistance after delivery.