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

Yan YanShanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of ChinaView further author information

Shihua BaoShanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of ChinaCorrespondence[email protected]
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Shile ShengRenji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of ChinaView further author information

Liuliu WangShanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of ChinaView further author information

Weiyan TuShanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of ChinaView further author information

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 CD3⁺CD4⁺ cell levels while CD56⁺CD16⁺cell 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 CD3⁺CD4⁺ 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

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Declaration of interests

This work was supported by grants from the Research Grant from Shanghai Committee of Science and Technology (No. 14411966600) and the Joint Key Project of New Frontier Technology in Shanghai Municipal Hospitals (No. SHDC12014129). The authors report no conflicts of interest.