Study Of The Relationship Between Gestational Diabetes Mellitus And Serum Ferritin In The Midtrimester Of Pregnancy

Objective: To investigate the role of Serum Ferritin in the etiopathology ofGestational Diabetes Mellitus.Methods: The singleton pregnancy of primiparous women at24to28weeks ofgestation who accepted antenatal examination in the obstetrics clinic of the firstaffiliated hospital of dalian medical university and Maternal and Child Health hospitalof Zhongshan District from August2012to December2012were selected，total of90cases were divided into two groups according to the clinical diagnostic criteria ofgestational diabetes which was released by the American Diabetes Association in2011.44cases of GDM pregnant women as GDM group，46cases of pregnant women withnormal glucose tolerance at the same time as the control, normal glucose tolerance(NGT) group. Height、age、gestational age、pregnant times、prepregnancy weight andweight of OGTT test before hemospasia and other related personal information wererecored in detail. Acute inflammation、infection、stress factors、other pregnancycomplications and related diseases was excluded. No history of trauma, surgery, bloodtransfusion and family genetic factors. The serum specimens were collected from twogroups: Serum Ferritin (SF)、Fasting Insulin (FINS) Glycosylated Hemoglobin Alc(HbAlc) were measured by the radio-immunity assay and the ionic exchange highperformance liquid chromatography. Hemoglobin (HB) and Fasting Plasma Glucose(FPG) were obtained from the routine examinations. Body mass index (BMI) wascalculated by measuring the height、 weight and weight before hemospasia of thepregnant women. Insulin secretion was assessed by the homeostasisβ-cell functionindex(HBCI)，and Insulin resistance by the homeostasis model insulin resistance index(HOMA-IR). SF level changes, the differences in insulin resistance and insulinsecretion cell function were compared between two groups, the relationship between them and their effect on the pathogenesis of GDM were analyzed.Results:(1) SF levels in GDM group was significantly higher than NGT group(P<0.05);(2) HOMA-IR in GDM group was higher than NGT group，HBCI in GDMgroup was lower than NGT group，there were significant difference (P<0.05);(3)HbAlc、HB and BMI before hemospasia in GDM group were higher than NGT group，there was significant difference (P<0.05);(4) Correlation analysis: SF of GDM groupcompared with HOMA-IR was positively correlation (r=0.334，P<0.05)，and SF ofGDM group compared with FPG、FINS、HB and HbAlc was positively correlation(r=0.350、0.336、0.369、0.364，P<0.05).Conclusions:(1) There are serious insulin resistance and insulin secretiondecrease in GDM pregnant women, both of them play an important role in thepathogenesis of GDM.(2) There are correlationship between high level SF in GDMpregnant women and insulin resistance,SF may participate in the pathogenesis of GDM.(3) SF can response iron storage in the body more sensitive and more accurate. SF、HBand related indicators should be monitored during pregnancy to guide the complementof iron agent in clinical.