Correlation Between Cord Blood RBP4Levels In Patients With GDM And Metabolic Indicators Of Newborns

Background:Gestational Diabetes mellitus is a common perinatal complication and harm to maternal and child, leads to energy metabolism disorders in pregnant women. It is association with a variety of adverse pregnancy outcomes, such as macrosomia, polyhydramnios, spontaneous abortion, fetal malformation, fetal distress, stillbirth, neonatal hypoglycemia, hypocalcemia, and hyperbilirubinemia, maternal ketoacidosis. Its pathogenesis is indefinite. In recent years, adipokines and their secreted factors, mediating the incidence of IR, has got our attention. Weight gain during pregnancy is the fastest accumulation of fat in women’s life. Socholars widely considerred that synthesis and secretion of adipocytokines are increased as the growth of the placenta and maternal accumulation of fat during normal pregnancy and play the role in the regulation of energy metabolism and regulating insulin activity. Human adipose tissue is one of the most important endocrine organ, synthesize and secrete a variety of adipocytokines, including leptin, adiponectin, tumor necrosis factor-α (TNF-α), interleukin-6(IL-6) and resistin, visfatin, apelin, fasting-induced adipose factor (FIAF), retinol-binding4(RBP4), Chemerin and so on.Retinol binding protein-4(RBP4) is a newly discovered adipocytokine mainly secreted by liver and fat cells, which can regulate glucose and lipid metabolism. RBP4is closely related to insulin resistance and metabolic syndrome.In recent years,there are many studies on the relationship between RBP4and maternal GDM, but few studies on the relationship between RBP4and newborn metabolic. To explore the correlation between RBP4and GDM newborn metabolic, We studied the change of core blood RBP4in patients with GDM and normal pregnant, and the relationship of RBP4and glucose and lipid metabolism related indicators in newborn.Objective To explore the correlation between the Umbilical cord blood RBP4levels in patients diagnosed with Gestational Diabetes mellitus (GDM) and some metabolic indicators of newborn.Methods Detect the levels of Umbilical cord blood RBP4, Fasting plasma glucose (FPG), insulin (Fins), Total Cholesterole (TC), Triglyceride (TG), High-density lipoprotein(HDL-C) and Low-density lipoprotein (LDL-C) levels in38patients with Gestational Diabetes mellitus and38normal control, then we explored the correlation between the Umbilical cord blood RBP4levels in patients with GDM and the metabolic indicators of newborns.Results (1) The neonatal birth weight and umbilical cord blood RBP4in GDM group was significantly higher than the control group (3.55±0.33kg,17.66±5.36ug/L and3.26±0.33kg,13.66±3.79ug/L, P<0.001);(2) cord blood TG, LDL, TC levels in GDM group were higher than the control group (0.47±0.23mmol/L,0.69±0.13mmol/L,1.54±0.51mmol/L and0.31±0.19mmol/L,0.58±0.10mmol/L,1.26±0.43mmol/L, P <0.05), while HDL level in GDM group was lower than the normal control group (0.66±0.19mmol/L and0.78±0.20mmol/L, P<0.05);(3) Fins in GDM group was higher than the normal control group (7.84±2.2mu/L and6.0±2.03mu/L, P<0.05), while the FPG in GDM group was lower than the normal control group (2.81±0.48mmol/L and3.14±0.23mmol/L, P<0.05);(4) Correlation analysis:RBP4were positively correlated with TG in normal controls group (R=0.58, P<0.001), while RBP4were negatively correlated with FPG (R=-0.43, P<0.01) and positively correlated with fins(R=0.47, P O.01)、birth weight (R=0.49, P<0.01) in GDM group.Conclusion (1) Cord blood RBP4was involved in energy metabolism of the fetal of GDM women;(2) GDM group exists fetal blood glucose and lipid metabolism, and correlated with umbilical cord blood RBP4concentration (3) However, the exact mechanism of how RBP4involves in the metabolism of the fetus still needs further studies.