The effect of mecobalamin combined with insulin on Toll-like receptor 4/myeloid differentiation factor 88 signaling pathway and maternal and infant outcome of gestational diabetes / 中国医师进修杂志

ABSTRACT

Objective:To explore the efficacy of mecobalamin combined with insulin in the treatment of patients with gestational diabetes (GDM) and its effect on Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) signaling pathway and maternal and infant outcomes.Methods:A total of 132 patients with GDM in the Fourth Central Hospital of Baoding City were selected and they were randomly grouped according to the principles of stratified random design and controlled design trials, with 66 cases in each group. The control group was treated with insulin, and the observation group was treated with mecobalamin combined with insulin. The curative effect, fasting blood glucose (FBG) and 2 h postprandial blood glucose (2 h PBG), TLR4, MyD88, tumor necrosis factor-α (TNF-α), white blood cells interleukin 1β (IL-1β) before and after treatment and infant outcomes were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.45%(63/66) vs. 84.85%(56/66), and the difference was statistically significant ( χ2 = 4.181, P<0.05). After 1, 2, 3 weeks of treatment, the levels of FBG and 2 h PBG in the observation group were lower than those in the control group: after 1week of treatment, the differences were statistically significant ( P<0.05). After 1, 2, 3 weeks of treatment, the levels of serum TLR4, MyD88, TNF-α, IL-1β in the observation group were lower than those in the control group: after 1 week of treatment, the differences were statistically significant ( P<0.05). The incidence of cesarean section, polyhydramnios, macrosomia and premature birth in the observation group were lower than those in the control group: 7.58%(5/66) vs. 21.21%(14/66), 4.55%(3/66) vs. 16.67%(11/66), 1.52%(1/66) vs. 13.64%(9/66), 3.03%(2/66) vs. 7.58%(5/66), the differences were statistically significant ( P<0.05). Conclusions:Mecobalamin combined with insulin can regulate the TLR4/MyD88 signaling pathway, which can help to control blood sugar and improve the maternal and infant outcomes.