Study Of The Change Of The Lipid Metabolism And Lipoxidity In Gestational Diabetes Mellitus

Objective:To investigate change of the lipid metabolism in thegestational diabetes mellitus(GDM) and the role in the etiopathology of theGDM. Methods:Blood glucose and insulin both at the each timid in the 75goral glucose tolerance test(OGTT) were measured with fastingtriacylglycerol(TG), total cholesterol (TC), high-density-lipoproteincholesterol (HDL-C), low-density-lipoprotein cholesterol (LDL-C) and freefatty acids (FFA) in 23 patients with GDM,22 patients with impairedglucose tolerance (IGT) and 25 normal glucose tolerance (NGT) pregnantcontrols.IR and the function of the pancreatic island were assessed by thehomeostasis model insulin resistance index(HOMA-IR) and homeostasisβ-cell function index(HBCI).Significances were tested between eachgroups and the relationship between fasting TG,FFA and insulin resistance,β-cell function was analysed. Results:(1)HOMA-IR was higher significantly in GDM group thanIGT group (P<0.01) and NGT group (P<0.01).HBCI in GDM group(P<0.05) and IGT group (P<0.05) were both lower than NGT group.(2)Thelevel of TG in GDM group was higher than IGT group (P<0.05) and NGTgroup (P<0.05).The level of FFA was higher in both GDM and IGT groupsthan NGT group (P<0.01 both).(3)There were significant positivelycorrelations between FFA and TG(r=0.377,P=0.009),TG and IR(r=0.297,P<0.021).FFA was negatively correlated with HBCI(r=-0.419,P=0.003). Conclusion:(1)The increase of insulin resistance and impaired β-cellfunction may be the causes of GDM;(2)The TG level in GDM increasedsignificantly,and may be the basis of the diabetes mellitus andcardiovascular diseases;(3)Serum FFA level was increased highly inGDM,ahead of the increase of IR,and resulted in the decrease of the β-cell function .Which was for the theory of lipotoxicity.