Influence Of Interaction To GDM From FGF-21 Level And The Gluolipid Metabolic Abnormalities In Pregnant Women In Late Pregnancy

Objectives 1 To detect the levels in serum of fibroblast growth factor-21 concentration and some parameters of glucose and lipid metabolism in GDM and non-GDM late pregnant women and to observed the differences of the two groups.2 To analyze the relationship between the metabolism of glucose,lipid metabolism and fibroblast growth factor(-21)and the incidence of gestational diabetes mellitus(GDM).Methods 1 150 cases of full-term pregnant women were as subjects.who were regularly examined in affilated hospital of North China University of science and technology from April 2015 to April 2016 we came to the Affiliated,and.All subjects were examed oral glucose tolerance test(OGTT)and devided GDM and non-GDM groups according to the2012 American Diabetes Association(ADA)diagnostic criteria for diabetes during pregnancy The GDM group included 63 cases and normal control group(n = 87).2Collected by questionnaire survey and interview model name,age,culture degree,parity and birth,family history,diet habit,actual body weight before pregnancy or pregnancy within 8 weeks of the first pregnancy test record weight,measurement of the object body,wait for admission after high weight,calculation of subjects pre pregnancy body mass index(BMI)and the increase in pregnancy body mass index(△BMI).3 All of the participants in pregnant women after admission were required overnight fasting 8-10 hours fasting blood glucose oxidase method was used to measure fasting blood glucose level;chemiluminescence immunoassay to detect the fasting insulin level by electrochemical;enzymic method was used to measure the fasting total cholesterol,glycerin three fat,high density lipoprotein cholesterol,low density lipoprotein cholesterol levels;using enzymelinked immunosorbent assay(ELISA)detection of serum fibroblast growth factor-21.Insulin resistance index(HOMA-IR)and pancreatic beta cell function index(HOMA-β)were calculated from the fasting blood glucose levels and fasting insulin levels measured by HOMA.4 SAS 9.2 software was used to statistical analysis,measurement data and practical t test;Single factor and the relationship between the dependent variable with Pearson correlation analysis,a relationship between the dependent variable and multiple independent variables of the independent variables with multiple stepwise regression method;Results 1 Comparison of general data in gestational diabetes mellitus group age,gestational age,height,weight,compared to pre pregnancy BMI before pregnancy,pregnancy weight and normal control group showed no significant difference(P > 0.05);gestational diabetes mellitus group BMI difference,fasting blood glucose,fasting insulin,insulin resistance index,triglyceride,low density lipoprotein,total cholesterol,fibroblast growth factor-21 were significantly higher than the normal control group,and the difference was statistically significant(P < 0.01);gestational diabetes mellitus group with high density lipoprotein,islet beta cell function index is lower than the normal control group,the difference was statistically significant(P < 0.01);2 The Pearson correlation analysis showed that fasting serum of healthy pregnant women in the fibroblast growth factor-21 concentration with age,height,body weight before pregnancy,pre pregnancy BMI,late pregnancy weight,fasting insulin,total cholesterol were not associated with;fasting blood glucose,insulin resistance index,triglyceride and low density lipoprotein were positively correlated(P < 0.01);and negatively correlated with maternal body mass index difference,beta cell function index,high density lipoprotein(P < 0.01).Triglyceride,high density lipoprotein and fasting blood glucose were independent factors of fibroblast growth factor-21.This group of women in pregnancy with diabetes in fasting serum fibroblast growth factor-21 content and age,height,gestational age,pregnancy weight difference index and insulin resistance index were positively correlated with no correlation;pre pregnancy weight,previous pregnancy BMI,late pregnancy weight,fasting blood glucose,fasting insulin,insulin resistance index,triglyceride,low density lipoprotein,total cholesterol level(P < 0.01);negatively correlated with high density lipoprotein levels(P <0.01).Fasting blood glucose,triglyceride and insulin resistance index were independent factors of fibroblast growth factor-21;3 The interaction analysis showed that fibroblast growth factor-21 levels and fasting blood glucose,insulin resistance index,islet cell injury,triglyceride,total cholesterol,low density lipoprotein abnormalities,abnormal high density lipoprotein abnormalities or excessive weight gain during pregnancy and other factors combined effects will lead to increased risk of gestational diabetes onset,It was found that the interaction between fibroblast growth factor-21 and total cholesterol was statistically significant.Conclusions 1 The level of serum fibroblast growth factor(-21)in women with gestational diabetes mellitus(GDM)is higher than that of normal pregnant women,which may be involved in the development and progression of gestational diabetes mellitus(GDM);2 gestational diabetes pregnant women serum fibroblast growth factor-21 level is affected by the pregnancy weight increment,fasting blood glucose,fasting insulin,insulin resistance index and lipid metabolic indexes;fasting blood glucose,triglyceride,insulin resistance index is the effects of fibroblast growth factor independent influence factor of-21.3 The combined effects of fibroblast growth factor(-21)and abnormal glucose metabolism and lipid metabolism may lead to an increased risk of gestational diabetes mellitus(DM).Fibroblast growth factor-21 has additive interaction with total cholesterol.