Insulin resistance in patients with recurrent pregnancy loss is associated with lymphocyte population aberration

Abstract

This study was designed to investigate the relationship of insulin resistance (IR) and cellular immune abnormalities associated with women with recurrent pregnancy loss (RPL). Women with RPL were divided into two groups according to their homeostasis model assessment for IR (HOMA-IR) scores. The IR group received metformin approximately 3 months before pregnancy. The percentage of lymphocyte subsets and other blood biochemical indices were tested. The HOMA-IR and fasting serum insulin levels were related to the percentage of lymphocyte subsets. The women with RPL had higher CD3 and CD3CD4 cell levels while CD56CD16cell levels were lower. A higher likelihood of cellular immune abnormalities was observed. Women with normal lymphocyte subsets had normal pregnancy outcomes. Metformin significantly downregulated CD3 and CD3CD4 cells and improved pregnancy outcomes. IR was associated with cellular immune abnormalities in RPL. The data suggests that metformin affected the immune/inflammatory response, which may regulate the cellular immune balance and improve pregnancy outcomes. Abbreviations RPL: recurrent pregnancy loss; IR insulin resistance; HOMA-IR: homeostasis model assessment for IR.

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

“…It has been demonstrated in mice that lymphocytes participate in the pathogenesis of IR (49). Yan et al found that a far greater proportion of newly diagnosed RPL patients with IR had an aberrant CD3 + CD4 + , and CD56 + CD16 + cell population compared to RPL patients without IR (34). Our study found that an increase in TG levels positively associated with an increased CD3 + CD4 + /CD3 + CD8 + ratio.…”

“…An increased ratio of CD4 + /CD8 + lymphocytes was found in lipopolysaccharide (LPS) challenged pigs (32). IR was reported to be related to the abnormal percentage of lymphocyte subsets in RPL (33,34). A recent study revealed that a decrease of regulatory B cells (CD19 + CD24 hi CD38 hi ) in peripheral blood is associated with IR, and can increase the risk of postprandial hyperinsulinemia (35).…”

“…A recent study revealed that a decrease of regulatory B cells (CD19 + CD24 hi CD38 hi ) in peripheral blood is associated with IR, and can increase the risk of postprandial hyperinsulinemia (35). Yan et al also demonstrated that IR was associated with cellular immune abnormalities in RPL patients (34).…”