Systematic Evaluation To Relationship Between Pro12Ala Polymorphism In PPAR γ2 Gene And Gestational Diabetes Mellitus

Gestational diabetes mellitus(GDM) was a condition of impaired glucose tolerance during pregnancy of women without previous diagnosis of diabetes which was also a common perinatal complications. it also was a heterogeneous disease, resulting from the interplay of genetic and environmental factors. The incidence of GDM is increasing year by year. Because of the complexity of the metabolism during pregnancy, GDM does serious harm to maternal, fetal, neonatal and developing children. To maternal, the damage mainly appears as pregnancy hypertension, preeclampsia, premature rupture of membranes of placental abruption and even abortion, and significantly increased risk of obtaining type 2 diabetes for postpartum women; to fetus, mainly as macrosomia, fetal abnormalities and brain damage; to developing children, mainly as limited development, cognitive dysfunction and increased risk of diabetes.The incidence of GDM is increasing year by year and the prognosis depends on early diagnosis and early prevention. At present, the routine screening for GDM is mainly using simple glucose screening test, oral glucose tolerance test and high risk factors in the second trimester(24~28 weeks). But there are many disputes between the routine screening and GDM. Many domestic and foreign scholars have carried out a large number of epidemiological survey of risk factors, etiology, basic research and clinical research to seek the best screening time, screening range, screening population, indicators, method for screening and diagnosis criteria and made new progress and understanding. How to establish a set of reasonable and efficient early screening program is particularly important. This study systematically evaluated the correlation between peroxisome proliferator activated receptor gamma 2 Pro12 Ala polymorphism(rs1801282) and GDM to provide evidence for screening index in the early diagnosis of GDM based medicine reference.ObjectiveTo evaluate the association of Pro12 Ala polymorphism in peroxisome proliferator activated receptor γ2(PPAR γ2) gene with GDM by systematically assessment and to provide evidence for screening index in the early diagnosis of GDM based medicine reference.MethodsPublications on genetic association studies of PPAR γ2 and GDM were searched using PubMed, Medline, Elsevier, Cochranelibrary, The HuGE Navigator, CNKI, Wanfang Data and VIP science from the inception of the databases to February 1, 2015. Two reviewers independently selected literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the data using the Newcastle-Ottawa Scale(NOS) standard. Meta-analysis was performed using the allele model, dominant genetic model analysis respectively. RevMan 5.3 software were used to pool the weighted mean differences(WMD) and Odds ratio(OR).ResultsA total of 13 articles were included, and 2787 cases of GDM and 5408 normal pregnant women were analyzed by Meta analysis in the results of evaluation between PPAR gamma 2 Pro12 Ala polymorphism and GDM.1. Pro12 Ala polymorphism in PPAR γ2(allele Ala or genotype Ala/Ala of Pro/Ala) was shown to be highly associated with GDM occurrence in general evaluation, with OR(95%CI) of 0.74(0.60~0.93) in the allele model and 0.79(0.65~0.96)in dominant genetic model(P<0.05, respectively).2. Pro12 Ala polymorphism in PPAR γ2 was shown to be highly associated with GDM occurrence in Asians in a stratification analyses by ethnicity for the populations of included studies, with OR(95%CI) of 0.61(0.48~0.79) in the allele model and 0.64(0.50~0.82) in dominant genetic model(P<0.05, respectively),whereas no correlation was found for Pro12 Ala polymorphism in PPAR γ2 with GDM in white people.3. A Meta-analysis of 6 Chinese literature showed that Pro12 Ala polymorphism in PPAR γ2 was associated in Chinese population with the risk of GDM, with OR(95%CI) of 0.52(0.36~0.73) in the allele model and 0.55(0.39~0.80) in dominant genetic model(P<0.05, respectively).Conclusion1. The Ala allele and the Ala/Ala or Pro/Ala genotypes of Pro12 Ala polymorphism in PPAR γ2 was associated with an decreased risk of GDM.2. Pro12 Ala polymorphism in PPAR γ2 can be incorporated into early screening indicators for GDM.