Maternal Serum TNF-α Concentration And The Correlation Between It And Maternal Insulin Resistance In Gestational Diabetes

Objective: To measure the serum tumor necrosis factor- (TNF-) levels and studied the contribution of the tumor necrosis factor to insulin resistance in gestational diabetes. Methods: 42 cases with GDM, 93 cases of normal pregnant women (28 in the first, 25 in the second, 40 in the third trimester) and 25 cases of normal non-pregnant women were studied. ELISA was used to measure the fasting TNF-a levels in patients with GDM, fasting plasma glucose, insulin, C-peptide and glycosylated hemoglobin(HbAlc) also be measured at the same time. Insulin resistance level evaluated by Homa model, Insulin resistance index was calculated by its formula.Results: (1) (3.41 0.32)ng/L, (3.59 0.46)ng/L, (3.83 0.47)ng/L, (4.51 0.46)ng/L, (5.19 1.57)ng/L were the mean TNF-a level of normal non-pregnant women, normal pregnant women (first, second, third trimester), patients with GDM respectively. Maternal serum TNF-a levels in pregnant women with GDM were significantly higher than those healthy pregnant women(P<0.01). Homa IR is (0.16 0.28), (0.17 0.24), (0.34 0.22), (0.65 0.28), (1.13 0.36) in the groups mentioned above. (2) The levels of fasting serum glucose, insulin, C-peptide and HbAlc values were(5.49 0.73)mmol/L, (13.41 3.82) uU/ml, (4.84 1.20)ng/ml, (5.6 0.5)%, (28.69 3.25)kg/m2, respectively, whereas the corresponding values in normal controls were significant lower. (3) A positive correlation was found between maternal serum TNF-a levels and Homa IR, fasting serum glucose, insulin, C-peptide, HbAlc levels and BMI in pregnant women with GDM(r=0.781, 0.512, 0.746, 0.629, 0.386, 0.455). A positive correlation was also found between maternal TNF-a concentrations and Homa IR, in normal pregnancy women not more correlations be found in addition to the positive correlations between TNF-aconcentrations and Homa IR and BMI.Conclusions: TNF-a may contribute to insulin resistance during pregnancy women withGDM.