The Expression And Significance Of VEGF And MMP-9 And IV-C In Gestational Diabetic Placenta

Objective:VEGF and MMP-9 and IV-C play an important role in Type 2 diabetic mellitus microangiopathy. Gestational diabetes mellitus is a special type of diabetes mellitus. This study is to investigate the expression and the clinical significance of VEGF and MMP-9 and IV-C in gestational diabetic placenta.Methods :A case-control study was performed in 48 women with gestational diabetes mellitus and 36 cases of normal 50g glucose challenge test ( 50g GCT) as control recruited from Jun 2007 to Des 2007 in Taiyuan Meternal and Infant Health Care Hospital . All the samples were gotten from the maternal surface of the placenta after the labor immediately. To compare the fetal outcomes, the placental weight, the pathological changes of the placental structure and the expression of VEGF, MMP-9 and IV-C in gestational diabetic placenta by immunohistochemistry way.Results:(1) The incidences of macrosomia, neonatal asphyxia, hyperbilirubinemia and polyerythromy in GDM group were significantly higher than those of control group (P<0.05);(2) Average placental weight and placental index of GDM group were significantly higter than those of control group (P<0.05);(3)The rates of the trophoblastic down arterial bifurcation tubal wall thickening, lumen narrowing , the immatural trophonema as well as the intervillous capillary enlargment in GDM grope were significantly higher than those in control grope(p<0.05).(4)The expression of VEGF, MMP-9 and IV-C in diabetic placenta was distinctly higher than that in control group (P<0.05);But if the blood glucose levels of pregnant women were normally controlled, the expression of VEGF, MMP-9 and IV-C was not significantly different with study and control groups ( P>0.05);(5)The expression of MMP-9 was significantly positively correlated with that of VEGF in gestational diabetic placental(χ~2=16.092, P<0.01,r=0.579);The expression of MMP-9 was significantly positively correlated with that of IV-C in gestational diabetic placental(χ~2=17.057, P<0.01,r=0.596).Conclusion :(1)The placenta pathological changes possibly are a series of adjustments of placenta itself under oxygen deficit condition, such as placenta enlarging. These changes may directly affect the placental blood and oxygen supply and result in problem neonatal outcomes.(2)The higher expression of VEGF, MMP-9 and IV-C means that they possible take part in the placenta pathological changes.(3)If the blood glucose levels of GDM patients are controlled immediately by reasonable treated,the expression of VEGF,MMP-9 and IV-C in gestational diabetic placenta couldn't increase . And in term, the placenta pathological changes and the complications of neonates may be decreased.