Study On The Relationship Between Serum Mannan-binding Lectin Level And Inflammational Factor, GDM

Objective(1)To observe serum concentration of the mannan-binding lectin (MBL) in normal pregnant women and gestational diabetes mellitus (GDM) women(2)To explore their correlations between MBL and inflammatory-related correlation factor such as C-reactive protein (CRP) and tumor necrosis factor (TNF-α), insulin resistance(IR),lipid metabolism indicators, its prognosis in GDM pregnant women(3)To grasp what MBL playing at the occurrence and development of GDM(4)To provide new ideas and methods for the prevention, treatment and prognosis of GDM. .Methods(1)First of all, gestational women in prenatal checked in the first Affiliated Hospital of Anhui Medical University were screened and diagnosed in GDM during Aug.2006 and Jan.2008. 30 of them were diagnosed with GDM, which were set as GDM group. Among the normal women in the same time, 30 were taken out to set as the normal comparison group.(2)Fasting plasma glucose(FPG),insulin,C-peptide, glucose challenge test(GCT), triglyceride(TC) and total cholesterol(TG)were also measured , meanwhile, pre- pregnancy body mass index(BIM) and homeosiasis model assessment (HOMA-IRI) were calculated.(3)Enzyme-linked immunosorbent assay (ELLIA)was used to measure the fasting serum MBL levels of 30 women with GDM and 30 cases of normal pregnant women .(4)ELLIA was used to measure inflammatory cytokine factor such as fasting serum CRP/TNF-αlevels of 30 women with GDM and 30 cases of normal pregnant women ,at the same.(5)The multiple stepwise regression analysis showed whether the low- lever MBLwas a important risk factor for GDM.(6)The GDM's group was divided into low-level MBL group and high-level group by average value of serum MBL level ,compared two groups of post-natal follow-up of the situation.Results(1)Significantly increased serum FPG, insulin, C-peptide,GCT,HOMA-IRI, TC and pre-pregnancy BMI were found in GDM women (4.7±0.8 mmol/l,18.1±3.4 IU/l,5.8±0.9mmol/l,13.1±0.9mmol/l ,3.9±1.2,6.3±0.7mmol/l,23.5±3.7 kg/m2) compared with those in healthy pregnant women (4.2±0.8mmol/l,13.5±2.6 IU/l,4.1±0.6mmol/l,9.2±0.2 mmol/l ,2.5±0.7,5.6±0.7 mmol/l,21.7±3.3 kg/m2),( P<0.01 or P﹤0.05 ) ,respectively. But there was no difference in TG between two groups. However,the results were the sames as the formers by adjusting BMI before pregnancy.(2)The obviously decreased serum MBL level was found in women with GDM (12.3±6.1ug/l) compared with healthy pregnant women at the same time(16.0±5.3ug/l) ( P<0.01).While,As was the same in two groups by covariance analysis after controlling BMI before pregnancy.(3)Evidently increased serum CRP and TNF-αwere found in GDM women (3.9±0.7 mg/l,38.8±5.6ng/l) compared with those in healthy pregnant women(2.5±0.6 mg/l ,25.7±2.4 ng/l). However,As were the sames in two groups by covariance analysis after controlling BMI before pregnancy.(4)Markedly positive linear correlations were showed between CRP,TNF-αand HOMA-IRI of GDM(r=0.891,0.782,P﹤0.01)by multiple linear regression method,but there was no correlation in TG between two groups.(5)Distinctly negative linear correlations were revealed between MBL and CRP,TNF-αof GDM(r=-0.720,-0.588,P﹤0.05 or P﹤0.01)by multiple linear regression method.(6)The visibly negative linear correlation was found between MBL and HOMA-IRIof GDM (r=-0.761,P﹤0.01)by multiple linear regression method.(7)The significatly negative linear correlation was found between MBL and FPG,GCT,TC of GDM (r=-0.701,-0.811,-0.692,P﹤0.01)by multiple linear regression method,but there was no correlation in TG between two groups.(8)The multiple stepwise regression ananlysis showed that factors for low MBL serum level,high pre- BMI,age ,et al were all increased the risk of GDM,which indicated that low MBL serum level be a independant risk factor.(9)A postpartum visit of 42 days displayed that low-lever MBL group had one womem with type-2 diabetes mellitus(T2DM)from GDM and five with impaired glucose toleran-ce(IGT),but high-lever MBL group had only one patient with IGT from GDM and nonewith T2DM.Low-lever MBL group was obviously higher than the high -lever MBL group about IGT by exact probability test(P<0.05),There was no correla -tion in incidence of T2DM between two groups(P>0.05).Conclusions(1)The serum levels of MBL in Gestational diabetes group are significantly lower than the control group.(2)MBL may be related to the pathogenesis of GDM as there is significantly negative linear correlations between MBLand CRP, TNF-α,FPG,GCT,HOMA-IRI, TC .(3)The mutiple stepwise regression analysis shows that MBL be a independant risk factor for GDM.(4)MBL may be a new target to determine prevention,treatment,and prognos of the GDM.