Metabolism And Insulin Resistance In Second Trimester Of Pregnancy Of Pregnant Woman

Objective:The aim of the study was to evaluate the levels of osteocalcin in second trimester of pregnancy of pregnant woma,analysis the relationships between OC and adiponectin,insulin resistance and the function of islet β-cell,as to explore the pathogenesis of gestational diabetes, and provided the new mentality for gestational diabetes prevention and control.Methods:According to 2013 ADA diagnostic criteria and OGTT results,choose 30 gestational diabetes women in GDM group and 30 women of normal glucose tolerance into NGT group,at the same time, choose healthy childbearing age women as controls. Glucose oxidase method is used to determine blood glucose levels, ria method of determination of serum insulin, ELisa method for determination of serum adiponectin and osteocalcin level, and then the homeostasis model assessment is used to calculate insulin resistance index HOMA-IR and β cell function HOMA-β, then do statistical comparison and correlation analysis.Results:1.The general clinical data and biochemical index comparison between three groups:The age, TG, TC, LDL-C, HDL-C of three groups, BMI before pregnant and BMI of NC,difference were no statistical significance(P>0.05), the gestational age and BMI increased during pregnancy between GDM and NGT was no statistically significant difference(P>0.05); FPG, 2 HPG and Hb A1 c of GDM were significantly higher than that of NGT and NC(P<0.01), FPG, Hb A1 c of NGT were significantly lower than that of NC(P<0.01); GDM group had a significantly higher FINS than NGT and NC(P<0.01),FINS of NGT is higher than NC, the difference was statistically significant(P<0.01);2.The HOMA-IR and HOMA-β comparison between three groups:The HOMA-IR of GDM was significantly higher than NGT and NC(P<0.01), HOMA-IR of NGT was higher than that of NC, the difference was statistically significant(P<0.05); HOMA-β of GDM was significantly higher than that of NC(P<0.01), HOMA-β of NGT was significantly higher than GDM and NC, differences were statistically significant(P<0.01);3.Serum osteocalcin and adiponectin level comparison between three groups:serum osteocalcin of GDM was higher than the NGT and NC,serum osteocalcin of NGT was higher than that of NC, differences were statistically significant(P<0.01);serum adiponectin of GDM was significantly lower than NGT and NC, the adiponectin of NGT was significantly lower than NC, the difference had statistical significance(P<0.01);4.Pearson correlation analysis showed that osteocalcin and FINS, HOMA IR is significantly related to the correlation coefficient of 0.537, 0.546, respectively(P<0.01);Adiponectin was inersely associated with homa-ir significantly negative correlation, the correlation coefficient is 0.462(P<0.01); In the control group, osteocalcin and adiponectin has significant positive correlation, the correlation coefficient was 0.489(P<0.01).Conclusion:1.There is insulin resistance in pregnant women, insulin resistance in GDM with glucose metabolic abnormalities is more serious;2.Serum osteocalcin leve in the pregnant women is higher than women of childbearing age without pregnancy, and serum osteocalcin levels were positively correlated with insulin resistance, we speculated that elevated serum osteocalcin levels may be a compensatory to insulin resistance in pregnant women of abnormal glucose metabolism;3.The serum adiponectin level of pregnancy women was significantly lower than the women of childbearing age without pregnancy, and serum adiponectin level was negatively correlated with insulin resistance, illustrate the serum adiponectin levels might contribute to insulin resistance and GDM.