| Objective To investigate the relationship beween the expression of tumor necrosis factor-a(TNF-a) in adipose, placenta and the insulin resistance in pregnant women with gestational diabetes mellitus (GDM).Methods The expression of TNF-a protein in adipose and placenta were determined in 48 pregnant women with GDM(group I: 30 cases BMI<30kg/ m~2 group II: 18 cases BMI ≥30 kg/m~2)and 50 pregnant women with normal glucose tolerance. The expression of the TNF-a mRNA were determined by reverse transcription polymerase chain reaction (RT-PCR). Radio-immunity assay was used to measure the fasting serum TNF-a levels of the groups;Fasting plasma glucose and insulin levels were also measured at the same time. Insulin sensitive index ( ISI) and insulin resistance index (IR) were calculated according to equations.Results (1) The levels of TNF-a mRNA in adipose in group I and group II were respectively 0.99±0.23 and 1.29±0.27,and they were significantly higher than those in control group (0.86±0.13 ) (P <0.05, 0.01) , while those in group II were higher than group I (p<0.01);At the same time,the levels of TNF-a protein in group I and group II were 163.032±16.240, 179.331 ±23.039, they were significantly higher than those in control group too (152.175±22.218) (P <0.05, 0.01), while those in group II were higher than I group (p < 0.01) . (2) The levels of TNF-a mRNA in placenta in control group and group I , II were respectively 1.08±0.19, 1.09±0.20 and 1.13±0.27;and the levels of TNF-a protein in three groups were respectively 150.946±12.127, 153.331±17.354, 154.618±19.237. There were no difference among the levels of TNF-a mRNA and TNF-a protein in placenta among the three groups (p>0.05) .(3) In three groups,there were significant correlations between serum TNF-a levels and HOMA—IR, ISI (in control group P < 0.05,in group I , IIP< 0.01) . (4) In control group and groups 1, II, there were significant correlations between TNF-a mRNA levels in adipose and serum TNF-a levels, HOMA—IR, ISI (P<0.05);and in the three groups,there were no correlations between TNF-a mRNA levels in placenta and serum TNF-a levels, HOMA—IR, ISI (p>0.05) .Conclusions (1) Higher expression of TNF-a in adipose is the main cause of insulin resistance in GDM .(2) There is no significant correlation between the expression of TNF-a in placenta and the insulin resistance. |
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