Serum Homocysteine Measurement And The Clinical Role In Gestational Diabetes Mellitus

Objective:To investigate the serum homocysteine (HCY) levels in gestational diabetes mellitus (GDM), and the clinical role of predicting the severity and the pregnancy outcome of that disease.Methods:153cases of GDM women were recruited as the observation group in HUZHOU Women’s and Children’s Hospital from1st May to31st August2012. Based on the blood glucose level, they were divided into two groups such as normal blood glucose group (A1) of106cases and abnormal blood glucose group (A2) of47cases. And90healthy women in the third trimester of pregnancy were randomly selected as the control group. Serum homocysteine levels were measured in all the cases. And the correlation between serum homocysteine levels and the progression and the pregnancy outcomes of that disease was studied. Results:There were no significant differences of pregnancies, parity and neonatal birth weight between gestational diabetes group and control group (p>0.05). But the maternal weight, age, gestational age, fasting blood glucose levels, homocysteine levels and the total number of adverse events of gestational diabetes group were significantly higher than those of the control group (p<0.05). The mean levels of homocysteine between group A1, group A2and control group are significantly different. The serum homocysteine level in group A2(11.376±3.477) was significantly higher than that in control group (8.862±2.557)(p<0.01), but it had no significant difference between group A1(9.169±2.457) and the control group (p>0.05). The serum homocysteine level in group A2was significantly higher than that in group A1(p<0.01).With comparison of maternal and neonatal outcomes between the GDM group and the control group, we found that the incidence of absent pregnancy outcome in GDM group was higher than that in control group, but not significantly. However, the overall incidence of adverse pregnancy outcome was significantly different between these two groups. The incidence of observe outcomes in group A2were higher than that in group A1, we found that the incidence of hypertensive disorders, premature birth and huge children were significantly different between these two groups, with the other complications were not significant different. The overall incidence of adverse outcomes in higher homocysteine group was significantly higher than normal level group. We grouped all subjects including control and GDM group by serum homocysteine into higher homocysteine group and normal homocysteine group, and we found that the incidence of huge children and hypoglycemia of newborn were significantly different between these two groups, with the other complications were not significant different. But overall incidence of adverse outcomes in higher homocysteine group was significantly higher than normal level group. When grouped GDM subjects by homocysteine, the incidence of huge children and hypoglycemia of newborn were significantly different between these two groups, with the other complications were not significant different. But overall incidence of adverse outcomes in higher homocysteine group was significantly higher than normal level group.Further logistic analysis revealed that the gestational age and serum homocysteine levesl are independent factors of adverse pregnancy outcome in GDM.Conclusion:Serum HCY levels are tightly related to the progression and pregnancy outcome of GDM. It might be an independent risk factor for GDM and require more clinical attention.