Metformin and insulin treatment of gestational diabetes: effects on inflammatory markers and IGF-binding protein-1 – secondary analysis of a randomized controlled trial

Table 2 Change in concentrations of inflammatory markers and IGFBP-1 phosphoisoforms from baseline to 36 gestational weeks

Variable	Metformin and insulin combined		Metformin		Insulin		p-value for comparison of changes (metf vs ins)
n	179		94		85
	median/mean (95% CI)	p-value	median/mean (95% CI)	p-value	median/mean (95% CI)	p-value
Inflammation
hsCRP (mg/L)	−0.47 [−1.3; −0.014]	0.011	−0.45 [−1.7; 0.16]	0.028	−0.47 [−1.8; 0.093]	0.18	0.72
IL-6 (ng/L)	0.70 [0.20; 1.40]	0.002	0.85 [0.50; 1.8]	0.002	0.62 [−0.19; 1.4]	0.13‡	0.31
MMP-8 (μg/L)	0.0 [−2.0; 0.80]	0.50	−0.70 [−2.0; 1.0]	0.76	0.70 [−2.0; 2.6]	0.20	0.28
GlycA (mmol/L)	0.11 [0.089; 0.13]	< 0.0001	0.15 [0.11; 0.18]	< 0.0001‡	0.091 [0.064; 0.12]	< 0.0001‡	0.020
IGFBP-1
Non-phosphorylated (μg/L)	17.0 [13.0; 20.5]	< 0.0001	21.0 [14.0; 26.0]	< 0.0001	13.4 [7.9; 18.9]	< 0.0001‡	0.008
Low-phosphorylated (μg/L)	6.0 [4.0; 7.9]	< 0.0001	6.0 [3.6; 7.5]	< 0.0001	4.0 [−2.0; 4.0]	0.021	0.081
High-phosphorylated (μg/L)	300 [190; 410]	< 0.0001‡	260 [110; 420]	0.001‡	340 [180; 500]	< 0.0001‡	0.48†

Median/mean change from baseline to 36 gestational weeks [95% confidence interval (CI)]. Positive values indicate increase and negative values decrease. p-values are given for the one-sample t-test (indicated with ‡) or Wilcoxon’s signed rank test (comparisons not indicated by ‡). For comparison of changes between metformin and insulin groups, Mann-Whitney’s U-test or the t-test (indicated with †) was used. hsCRP = high sensitivity CRP, IL-6 = interleukin 6, MMP-8 = matrix metalloproteinase 8, GlycA = glycoprotein acetylation, IGFBP-1 = insulin-like growth factor-binding protein 1. n-values for GlycA are 190, 99 and 91 for combined, metformin and insulin groups, respectively

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