| Pregnancy with gestational diabetes including pregestational diabetes mellitus and gestational diabetes mellitus,the former is patients with diabetes patients found before pregnant,and gestational diabetes mellitus occurred for the first time during pregnancy or discovery of glucose intolerance,is characterized by high blood glucose.High blood glucose increases glucose oxidation and oxygen consumption,which leads to excessive fetal blood oxygen consumption and lack of oxygen.Hypoxia inducible factor(HIF)is currently the one found in the specificity of anoxic state,plays an active sensitive transcription factor,it combines with target genes,such as erythropoietin,vascular endothelial growth factor and hemeoxygenase-1 gene by promoting the target gene transcription,and participates in the body's response to hypoxia caused by a variety of pathological physiological reaction.Objective: Study the expression of HIF in gestational mother and baby,test the effects of maternal blood,umbilical cord blood HIF and expression of placental tissue HIF and the relationship between blood glucose control situation and HIF.Explore placental hypoxia inducing factor(HIF)-1 alpha m RNA element in pregnant women with diabetes mellitus,and the relationship with birth weight and fetal Visfatin.Methods: Pregnant women with gestational weeks during thirty-seven to forty,they were divided into pregestational diabetes mellitus group(n=15),gestational diabetes mellitus group(n=30)and normal group(n=30).ELISA method was used to detected maternal serum HIF-1?,umbilical serum HIF-1?,RT-PCR method was used to measure placenta HIF-1? m RNA level.ELISA method was used to detected cord blood plasma concentration of Visfatin,and recorded birth weight of all neonates.Result: 1.There are no significant differences about age and gestational weeks among these three groups(P>0.05).2.Maternal serum HIF-1? in pregestational diabetes mellitus group were 78.42±11.85 pg/L which was significantly higher than that of gestational diabetes mellitus group(58.68±18.10)pg/L or normal group(47.96±12.79)pg/L(P<0.05).Maternal serum HIF-1? level in gestational diabetes mellitus group were also higher than normal group obviously(P<0.05).3.Umbilical serum HIF-1? in pregestational diabetes mellitus group were 65.33±11.65pg/L which significantly higher than that of gestational diabetes mellitus group(45.31±13.81)pg/L and normal group(35.35±12.83)pg/L(P<0.05).Umbilical serum HIF-1? level in gestational diabetes mellitus group were also higher than normal group obviously(P<0.05).4.Placenta HIF-1? m RNA level in pregestational diabetes mellitus group were 0.43±0.12 which was significantly higher than that of gestational diabetes mellitus group 0.23±0.06 or normal group 0.19±0.08(P<0.05).Placenta HIF-1? m RNA level in gestational diabetes mellitus group were also higher than normal group obviously(P<0.05).5.Cord blood plasma concentration of Visfatin in pregestational diabetes mellitus group were 13.53±1.83 which was significantly higher than that of gestational diabetes mellitus group 8.69±2.37 and normal group 7.84±2.40(P<0.05).Cord blood plasma concentration of visfatin in gestational diabetes mellitus group were not different from normal group obviously(P> 0.05).6.Birth weight of fetus in pregestational diabetes mellitus group were 3.81±0.46 which was significantly higher than that of gestational diabetes mellitus group3.43±0.45 or normal group 3.22±0.36,(P<0.05).Birth weight of fetus in gestational diabetes mellitus group were not different from normal group obviously(P> 0.05).7.Maternal serum HIF-1? is correlated with umbilical serum HIF-1? and placenta HIF-1? m RNA level positively(r= 0.543,P<0.05;r= 0.434,P<0.05).8.Placenta HIF-1? m RNA was positively(r=0.557,P<0.05;r=0.411,P<0.05)correlated with cord blood plasma concentration of Visfatin and birth weight;cord blood plasma concentration of Visfatin was positively(r=0.406,P<0.05)correlated with birth weight.9.Expression of HIF-1? in the placenta tested by histopathologic method was strong positive in pregestational diabetes mellitus group,and that of gestational diabetes mellitus group was positive,while that of control group was negative.Conclusion: 1.Blood glucose control in pregestational diabetes mellitus group was worst,maternal serum HIF-1?,umbilical serum HIF-1? and placenta HIF-1? m RNA level were highest.Maternal serum HIF-1? is correlated with umbilical serum HIF-1? and placenta HIF-1? m RNA level.Maternal serum HIF-1? can reflect the severity of pregnancy related diabetes mellitus.2.Maternal serum HIF-1? is correlated with umbilical serum HIF-1? and placenta HIF-1? m RNA level positively,which can reflect the control of blood glucose.3.Placenta HIF-1? m RNA was positively correlated with cord blood plasma concentration of Visfatin and birth weight;blood glucose control could make cord blood concentration of Visfatin and birth weight in gestational diabetes mellitus group normal nearly. |
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