Study On The Correlation Of Serum Adiponectin And Resistin And Gestational Diabetes Mellitus Pregnant Women.

IntroductionGestational diabetes mellitus (GDM) refers to the first occurrence of the abnormalities of carbohydrate metabolism to different extent during pregnancy and it is one of the most common complications during pregnancy. GDM seriously threatens the health of pregnant women, fetus and neonates, which can easily lead to macrosomia, polyhydramnios, gestational hypertension and neonatal complications et al. The mechanism of GDM is remain unknown, and the present opinion is that the insulin resistance and the decrease of the secretion of islet beta cell are important parts in the pathogenesis of GDM. New investigations find that adiponectin and resistin are both cytokines secreted by adipocytes, and related studies show that they have close relationship with obesity and diabetes mellitus, which have important significance for the screening, predication, prognosis of diabetes mellitus and provide theoretical basis for its treatment. However, further studies concerning the relationship between GDM and adiponectin and resistin are still needed.Our study evaluates the serum concentration of adiponectin and resistin in pregnant women with different carbohydrate tolerance and perform correlation analysis with body weight index (BMI) and insulin resistance index, then investigate the relationship between adiponectin, resistin and GDM, and their relevance in the pathogenesis of GDM.Methods50-g glucose screening test was conducted for many cases pregnant women at 28-32 weeks of pregnancy. If the blood sugar value was abnormal to examine with oral glucose tolerance test (OGTT). According to the result of OGTT, three groups were divided. The first group was 30 cases of normal glucose tolerance (NGT), the second group was 21 cases of impaired glucose tolerance (GIGT), the third group was 32 cases of gestational diabetes mellitus (GDM). ELISA technique was employed to determine the serum adiponectin and resistin concentration, at the same time the fasting blood glucose, insulin concentration were detected. Insulin resistance index was calculated by HOMA, and the dependability of index was analyzed.ResultsIn the NGT, GIGT and GDM groups the serum adiponectin level tended to decrease gradually in turn (P<0.01), NGT8.52±1.69mg/L,GIGT5.88±2.97mg/L,GDM4.37±2.43mg/L, but the level of serum resistin tended to advance gradually in turn (P<0.01), NGT6.45±1.02ug/L,GIGT9.11±3.82ug/L,GDM10.63±4.13ug/L. Serum adiponectin correlated negatively with insulin resistance index, fasting blood glucose and BMI (P<0.01), whereas resistin correlated positively with the index above(P< 0.01), serum adiponectin correlated negatively with resistin of GDM(r=-0.842,-0.856, P<0.01).DiscussionAdiponectin and resistin, secreted by adipocytes, are adipose tissue specialized plasma protein, which have close relationship with obesity, insulin resistance, type 2 diabetes and atherosclerosis et al. Our study showed that in the NGT, GIGT and GDM groups, the serum adiponectin level tended to decrease gradually in turn, but resistin level tended to increase, which indicated that adiponectin was a protecting factor of GDM, while resistin was a promoter. For the further investigation of the correlation between adiponectin and resistin in the pathogenesis of GDM, we evaluated the height and weight of pregnant women, fasting blood glucose, fasting blood insulin, BMI, IR, and performed correlation analysis. The result showed that serum adiponectin correlated negatively with IR, but resistin correlated positively with IR, which suggested that adiponectin and resistin could act on GDM through the varying of IR. Low adiponectin level, high resistin level have high risk correlation with the pathogenesis of GDM, and have important significance for the screening, predication, prognosis of diabetes mellitus, which will provide new theoretical basis for the diagnosis and treatment of GDM..Conclusion1. Adiponectin is one of a protecting factor for GDM, a insulin sensitizer, which can decrease insulin resistance index (IR); Resistin can promote the progress of GDM and increase IR.2. Adiponectin and resistin act reversely in the progress of GDM, antagonize each other in dose, and restrict each other in function.3. Adiponectin and resistin could act on GDM may be through the varying of IR, and raising adiponectin level, reducing resistin level can be a new target of the treatment of GDM in the future.