Triglyceride Induced Metabolic Inflammation: Potential Connection of Insulin Resistance and Recurrent Pregnancy Loss.

Yongjie Liu,Jun Zhang,Yuexin Gan,Shihua Bao,Liping Feng,Mengyang Du

doi:10.3389/fendo.2021.621845

Abstract

The underlying correlative mechanisms between Insulin resistance (IR) and recurrent pregnancy loss (RPL) in patients without polycystic ovarian syndrome (PCOS) remain inconclusive. To investigate the association between triglyceride (TG) levels, lymphocyte subsets, and IR in RPL patients without PCOS and obesity. Eighty-nine subjects with an unexplained RPL, independent of PCOS/obesity were enrolled in this study. A 75-g oral glucose tolerance test was performed on each subject with plasma tested for glucose and insulin. The fasting venous blood of all subjects was collected for routine clinical chemistry analysis. Lymphocyte subsets were analyzed by four-color flow cytometry. As a result, TG levels were significantly elevated in RPL patients with IR compared to those without IR. Pearson linear correlation model and receiver operating characteristic (ROC) curve analyses revealed a significant positive association between TG and HOMA-IR index value. In multiple logistic regression analysis, TG was significantly associated with the risk of hyperinsulinemia and increased CD3+CD4+/CD3+CD8+ ratio which was significantly negatively correlated with disposition index (DI30) and DI120, indicators for insulin sensitivity. In addition, DI30 and DI120 were significantly decreased in the higher CD3+CD4+/CD3+CD8+ group. Our findings showed that the elevated TG and altered immune responses in RPL patients with IR are independent of PCOS and obesity, and could be used as an indicator of IR in RPL patients. These results contribute to the understanding of the pathophysiology of IR in RPL for potential prevention and therapeutic targets.

Highlights

Miscarriage, the most common complication of pregnancy, is the spontaneous loss of a conceptus before 20 weeks’ gestation, and it affects approximately 15% of reproductive-age women recognized clinically [1]
Using a unique cohort of Recurrent pregnancy loss (RPL) patients without polycystic ovarian syndrome (PCOS) and obesity, we found increased TG levels in subjects with Insulin resistance (IR) compared to those without IR
Our study suggests that elevated TG and altered immune response are associated with insulin resistance in this cohort of RPL patients

Summary

Introduction

Miscarriage, the most common complication of pregnancy, is the spontaneous loss of a conceptus before 20 weeks’ gestation, and it affects approximately 15% of reproductive-age women recognized clinically [1]. There are two types of miscarriage: sporadic and recurrent. Recurrent pregnancy loss (RPL), defined as three or more consecutive pregnancy losses, occurs in approximately 1% of childbearing couples [2]. Many clinicians define RPL as two or more losses, due to the recurrence rate is similar to that after three losses, and it affects around 1% to 5% of couples [2–4]. RPL has been attributed to either genetic, structural, infective, endocrine, immune, or unexplained causes [2, 5–8]. Endocrine disturbances have been postulated as an important cause of RPL, which widens the scope of investigation

Methods

Results

Conclusion