| ObjectiveThe study aimed to detect the expression level of Chemerin and Irisin in maternal blood,cord blood and placenta tissue between the study targeted and combine with their pregnancy outcomes,to analysis their role in development of GDM and their influence in pregnancy outcomes.The ROC Curve were combined to further explore whether the determination of Chemerin and Irisin level can be used for the diagnosis of GDM.Methods1.The study includes 120 pregnant women at the same period of pregnancy who regular prenatal care and delivery in Jiangsu Subei People’s Hospital maternity department from June 01,2017 to December 31,2017.According to the ninth edition of journal of obstetrics and gynecology the diagnosis of GDM group:70 GDM pregnant women as GDM group,and 50 normal pregnancy as control group.According to different methods of intervention,GDM group 70 cases was further divided into 58 cases in the diet-control group,12 cases in the insulin-therapy group.All subjects included in the standard.Data collected included general conditions,clinical index of blood sugar and maternal and neonatal outcomes.2.Determine the level of Chemerin and Irisin for all studied groups maternal blood plasma、cord blood plasma with enzyme linked immunosorbent assay(ELISA).3.Determine the level of Chemerin and Irisin for all studied groups placental tissue with Immunohistochemistry.4.Correlation analysis according to the level of Chemerin and Irisin combined with clinical index of blood sugar.5.According to whether there is any adverse pregnancy outcomes of the pregnant women and newborns in the GDM group,it can be divided into two subgroups(good pregnancy outcomes group and adverse pregnancy outcomes group),compared the expression level of two groups of Chemerin,Irisin in maternal blood,cord blood and placenta tissue.6.Draw ROC curve according to the level of Chemerin and Irisin in maternal blood,cord blood and placenta tissue,further to choose the best diagnostic thresholdResults1.Analysis of general informationHeight of GDM group is lower than control group,pregnant women before delivery BMI and newborn weight of GDM group are obviously higher than that of control group(P<0.05),while there are no differences between the two subgroups in GDM(P>0.05).2.Analysis result of blood glucose clinical indexThe OGTT,OGTT1h,OGTT2h blood glucose of GDM group are higher than control group,neonatal blood sugar in GDM group is significantly lower than the control group(P<0.05),while there are no differences between the two subgroups in GDM(P>0.05).FPG before delivery of GDM insulin-therapy group is higher than control group and GDM diet-control group(P<0.05).3.The result of enzyme linked immunosorbent assay(ELISA)3.1 The expression level of ChemerinThe Chemerin level of mother and cord blood of GDM group are significantly higher than control group(P<0.05),while there are no differences between the two subgroups in GDM(P>0.05).3.2 The expression level of IrisinThe Irisin level of mother and cord blood of GDM group are lower than control group(P<0.05),while there are no differences between the two subgroups in GDM(P>0.05)4.The result of Immunohistochemistry4.1 Chemerin in the tissue of the placentaChemerin mainly expressed in the cytoplasm and cell membrane and the positive expression is yellow or tan.The content of Chemerin in placental tissue of GDM group was significantly higher than normal control group(P<0.05),while there is no difference between the two subgroups in GDM(P>0.05)4.2 Irisin in the tissue of the placentaIrisin mainly expressed in the cytoplasm and cell membrane and the positive expression is yellow or tan.The content of Irisin in placental tissue of GDM group was significantly lower than normal control group(P<0.05),while there is no statistical significance between GDM insulin-therapy group and diet-control group(P>0.05).5.Correlation analysis result5.1 The correlation analysis between Chemerin level and clinical index of blood sugarChemerin level in maternal blood,cord blood and placenta are positively correlated with OGTT,OGTT1h,OGTT2h blood glucose,FPG before delivery and neonatal blood sugar(P<0.05).5.2 The correlation analysis between Irisin level and clinical index of blood sugarIrisin level in maternal blood,cord blood and placenta are negatively correlated with OGTT,OGTT1h,OGTT2h blood glucose,FPG before delivery and neonatal blood sugar(P<0.05).5.3 The correlation analysis between the level of Chemerin and IrisinChemerin and Irisin levels are not correlated in maternal blood,cord blood and placenta(P>0.05)。6.The comparison of pregnancy outcomes6.1 The comparison of different childbirth wayThe incidence of cesarean section in the GDM insulin-therapy group is higher than that in the GDM diet-control group and the normal control group,but there is no statistically significant difference(P>0.05)6.2 The comparison of the adverse pregnancy outcomesThe incidence of neonatal hypoglycemia in GDM diet-control group and insulin-therapy group are significantly higher than the control group(P<0.05),while no statistical difference between the two subgroups in GDM(P>0.05).The incidence of hydramnios,postpartum fever,ketoacidosis,fetal distress,macrosomia,fetal growth restriction and premature babies,NRDS and others in GDM group are higher than in control group,but there is no statistically significant difference(P>0.05).7.Relations between the level of Chemerin and Irisin and pregnancy outcome7.1 Relations between the level of Chemerin and pregnancy outcomeThe level of Chemerin in maternal blood,cord blood and placenta in good pregnancy outcomes group is lower than that in adverse pregnancy outcomes group,the difference is statistically significant(P<0.05).7.2 Relations between the level of Irisin and pregnancy outcomeThe level of Irisin in maternal blood,cord blood and placenta in good pregnancy outcomes group is higher than that in adverse pregnancy outcomes group,the difference is statistically significant(P<0.05).8.ROC curve analysis result8.1 The diagnosis value of Chemerin for GDMThe AUC of Chemerin in maternal blood,cord blood and placenta tissue are 0.745,0.732 and 0.898,respectively,and P<0.05,the level of Chemerin detection used in the diagnosis of GDM has certain accuracy.8.2 The diagnosis value of Irisin for GDMThe AUC of Irisin in maternal blood,cord blood and placenta tissue are 0.734、0.710 and 0.700,respectively,and P<0.05,the level of Irisin detection used in the diagnosis of GDM has certain accuracy.Conclusions1.The levels of Chemerin is higher and the Irisin is lower in pregnant women with GDM than the normal pregnant women.Both of them may be related to the occurrence and development of GDM.2.The high expression of Chemerin and the low expression of Irisin may be associated with the adverse pregnancy outcomes in GDM.3.The level of Chemerin and Irisin may have certain accuracy in the diagnosis of GDM. |
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