The Study Of The Relationship On Visfatin And Gestational Diabetes Mellitus

Objective:To study serum and tissue visceral fat hormone (visfatin) levels in pregnant women. To investigate the relationship between visfatin expression and the the progress of gestational diabetes.Methods:106 pregnant women underwent cesarean section in the Second Hospital of Tianjin Medical University entered in this study. All women were excluded acute inflammation, gestational hypertension, liver and kidney disease, polycystic varian syndrome, cancers and other endocrine disorderd. According to diagnostic criteria for diabetes, the women were divided into three groups. Gestational diabetes mellitus group (GDM, n=50), the group with gestational impaired glucose tolerance (GIGT, n=24), the control group with normal glucose tolerance (NGT, n=32). Recorded the clinical and perinatal data. Serum visfatin levels were measured by ELISA method.The tissue specimens such as subcutaneous fat, omentum and fetal membranes were collected in order to measure the the visfatin mRNA expression with RT-PCR. Analyze the difference among these groups.Results:1. The pre-pregnancy body mass index (BMI) in GDM group was significantly higher than GIGT group and NGT group (P<0.05). While the difference between GIGT and NGT group was not significant (P=0.424). The average body weights at time of delivery in these three groups were different (F=7.672, P=0.001). The average body weight in GDM group was significantly higher than GIGT and NGT group (P<0.05), then there was no significant difference between the latter two groups (P=0.287). In GDM group, the average weight gain during the whole pregnancy was (18.63±5.58)Kg, which was significantly higher than NGT group (P =0.001), but was not significant different from GIGT group (P=0.059). In GDM group,86.0% of pregnant women gained body weight more than 12.5Kg, the proportion in GIGT the NGT group was 75.0% and 62.5%, the difference was significant (F=6.013, P=0.049).2. There were significant differences in lipid levels among these three groups(P <0.05). TC, TG and LDL levels in GDM group were all significantly higher than GIGT and NGT groups(P<0.05). There were positive relationships between serum visfatin level and TC and TG levels (P=0.049,0.048;r1=0.53, r2=0.42).3. HOMA-insulin resistance index in GDM group(HOMA-IR) was higher than GIGT group and NGT group (F=16.160,P=0.001)). However, HOMA-IR difference between GIGT group and NGT group was not significant (P=0.279). There was no significant difference about insulin level in these three groups (F=0.307,P=0.736).4. The serum visfatin level in GDM group(84.04±22.15 mmol/L) was higher than GIGT group (65.71±13.38 mmol/L) and NGT group (56.11±10.39 mmol/L), The differences were all statistically significant (F=26.562,P=0.001); The serum visfatin level in GIGT group was also higher than NGT group. The differences were all statistically significant (P=0.017)).5. The visfatin mRNA expression in subcutaneous adipose tissue in GDM group was higher than GIGT group,NGT group (F=10.53,P=0.001), while the difference between GIGT and NGT groups was not significant (P=0.325).6. The visfatin mRNA expression level in omental fat tissue in GDM group was higher than GIGT and NGT group (F=12.45,P=0.001), while the difference between GIGT and NGT groups was not significant (P=0.276)7. The visfatin mRNA expression level in fetal membranes in GDM group was higher than GIGT and NGT group (F=16.80,P=0.001), while the difference between GIGT and NGT groups was not significant (P=0.136).8. With overall as the research object,there is positive correlation between serum visfatin levels and the mRNA expression of subcutaneous adipose tissue,omental fat tissue and fetal membranes,TC,TG,BMI and the birth weight of infant (P=0.049,0.048;0.059,0.056;r=0.53,0.32,0.34,0.42),There is no correlation between visfatin expression and LDL,HDL (P>0.05).9. The birth weight, meconium-stained and the probability into the intensive care room in GDM group was significantly higher than GIGT group and NGT group. The differences are statistically significant (P<0.05).But There is no significan difference between GIGT group and NGT group t (P>0.05). Moreover, the 8 newborns who are transferred to NICU treated discharged from hospital after 3-10 days.Two neonatal appear hypoglycemia,a neonatal outbreak,atypical pneumonia,a newborn appears RDS in this period. In addition to four cases of GDM postpartum and three cases of GIGT postpartum patients after 42 days, all prenetal abnormal-glucose patients carry on 75gOGTT,including two cases of GDM,1 case of GIGT blood glucose is still abnormal,who are missed prenatal DM,others resume normal.Conclusions:visfatin is a new reported adipose factor. In gestational diabetes patients, visfatin mRNA expression are increased both in omentum, subcutaneous adipose tissues and fetal membranes, resulting in the elevation of serum visfatin level, which is associated with insulin resistance. Pre-pregnancy body mass index, weight-gain during pregnancy and elevated blood lipids are related with the increased visfatin expression.Its level is still concerned with perinatal outcome. The research of visfatin provides a new perspective to explore the mechanism of gestational diabetes. Visfatin is an useful factor for therapy guidance and disease monitoring.