The Relationship Between Fetal Insulin-like Growth Factor-â…  And Glycosylated Hemoglobin In Mother With Abnormal Glucose Metabolism

Objective:To determine the relationship between maternal Glycosylated hemoglobin levels in mother with abnormal glucose metabolism and cord blood insulin-like growth factor-Ⅰlevels in their newborns.Methods:Case-control study.30 term newborns of mothers with normal glycometabolism (control group) and 26 newborns of mothers with abnormal glycometabolism (24 with gestational impaired glucose tolerance'GIGT group'and 12 with gestational diabetes mellitus'GDM group') and their mothers were included. Cord blood was taken from umbilical vein at birth. Maternal serum was taken in one week before delivery. Maternal serum Glycosylated hemoglobin levels and cord blood insulin-like growth factor-Ⅰwere measured, and birth weights were recorded. The data was assayed by SPSS 17.0. Sample means were compared with One-Way Anova. Correlation was analyzed by Pearson Correlation coefficients.Result:1 Levels of maternal HbAlc in the late pregnancy (means+/-Standard deviation):Control group 6.06+/-0.60%, GIGT guoup 6.47+/-1.03%, GDM group 7.20+/-1.18%. The levels of maternal HbAlc were significantly different among three groups (P<0.05). By multiple comparison, the levels of maternal HbAlc was higher in GDM group than in control group (P<0.05). But no difference was found between the other two groups:Comparison of the levels of maternal HbAlc in the late pregnancy between control group and GIGT group shows no significant difference (P=0.331); Comparison of the levels of maternal HbAlc in the late pregnancy between GIGT group and GDM group shows no significant difference (P=0.081).2 Levels of birth weight (means+/-Standard deviation):Control gruop 3266.67+/- 305.27g, GIGT group 3792.00+/-380.82g, GDM group 3528.33+/- 433.36g. The levels of birth weight were significantly different among three groups (P<0.001). By multiple comparison, the levels of birth weight was higher in GIGT group than in GDM group (P<0.001). But no difference was found between the other two groups:Comparison of the levels of birth weight between control group and GDM group shows no significant difference (P=0.141); Comparison of the levels of birth weight between GIGT group and GDM group shows no significant difference (P=0.116).3 Levels of cord blood IGF-Ⅰ(means+/-Standard deviation):Control gruop 58.42+/-16.71μg/L, GIGT group 81.66+/-26.30μg/L, GDM group 77.05+/- 20.81μg/L. The levels of cord blood IGF-Ⅰwere significantly different among three groups (P<0.05). By multiple comparison, the levels of cord blood IGF-Ⅰwas higher in GIGT group than in control group (P=0.001). But no difference was found between the other two groups:Comparison of the levels of cord blood IGF-Ⅰbetween GDM group and control group shows no significant difference (P=0.063); Comparison of the levels of cord blood IGF-Ⅰbetween GIGT group and GDM group shows no significant difference (P=1.00).4 No correlation was found between maternal plasma HbAlc in the late pregnancy and birth weight (Pearson Correlation Coefficients=0.203, P=0.103).5 Cord blood IGF-Ⅰshowed positive correlation with birth weight (Pearson Correlation Coefficients=0.715, P<0.001). Linear regression was found between cord blood IGF-Ⅰand birth weight (R2=0.511, P<0.001).6 Maternal plasma HbAlc in the late pregnancy showed positive correlation with cord blood IGF-Ⅰ(Pearson Correlation Coefficients=0.322, P<0.05). Linear regression was found between maternal plasma HbAlc in the late pregnancy and cord blood IGF-Ⅰ(R2=0.104, P<0.05).Conclusion:1 The levels of maternal plasma HbAlc in the late third trimester is higher in GDM than in normal population. Suggest that GDM may have poor glycemic control. More active monitoring and correct clinical intervention are needed, in order to minimize maternal and child diseases and complications.2 The levels of birth weight is higher in GIGT than in GDM. Suggest that GIGT is more likely to give birth to macrosomia.3 The levels of IGF-Ⅰof cord blood of newborns of GIGT is higher than that of normal population. Suggest that affected by the high level of IGF-Ⅰin utero. the fetus of GIGT have the trend of excessive growth.4 There is no correlation between maternal plasma HbAlc in the late third trimester and birth weight. Suggest that maternal plasma HbAlc in the late third trimester cannot predict birth weight; Birth weight may be affected by multiple factors such as placental factors, etc.5 Cord blood IGF-Ⅰshows positive correlation with birth weight, and linear regression can be found between them. Suggest that levels of cord blood IGF-Ⅰcan reflect the situation of human fetal development.6 Cord blood IGF-Ⅰshows positive correlation with maternal plasma HbAlc in the late third trimester, and linear regression can be found between them. Suggest that to some extent maternal plasma HbAlc in the late third trimester can reflect fetal endocrine factors, IGF-Ⅰlevels, regardless of other factors except factor of blood glucose. It stresses the importance of late pregnancy maternal plasma HbAlc testing, and active controlling of blood glucose to reach the desired level, so that the fetus can have a more healthy environment for the growth and development, and the incidence of neonatal disease can be reduced.