The Research Of Relationship Between Betatrophin And Maternal-Fetal Glycolipid Metabolism In Different Therapies Of Gestational Diabetes Mellitus

Aim:To explore the relationship between Betatrophin and maternal-fetal Glycolipid metabolism in the pregnant with gestational diabetes mellitus(GDM)treated with medical nutrition or insulin,and the predictive value of evaluating therapeutic effect.Methods:From December 2016 to February 2018,60 GDM women who carried out regular prenatal examination and delivered in Qingdao municipal hospital and their newborn were selected and equally divided into the medical nutrition therapy group(refer to as the medical group)and the insulin therapy group(refer to as the insulin group).Plasma Betatrophin was detected with Elisa.Placenta Betatrophin protein was detected with Western blot,while placenta Betatrophin mRNA was detected with Q-PCR.The biochemical indexes were detected by automatic biochemical analyzer,including maternal fasting plasma glucose(FPG),hemoglobin A1c(HbA1c),glycosylated serum protein(GSP),fasting insulin(FINS),cord blood glucose,cord blood insulin,triglycerides(TG),and total cholesterol(TC).The insulin resistance index HOMA-IR was calculated by formula.Using statistical software to analyze the results and draw conclusions.Results:1)There's no statistically significant difference in age,number of pregnancies,number of births,gestational age,pre gestational BMI(P>0.05)between the two groups,except ABMI(P<0.05),which the medical group was statistically higher than the insulin group.2)The plasma Betatrophin positively correlated with maternal FPG,TG,FINS,HOMA-IR and cord blood Betatrophin,glucose,insulin and TG(P<0.05)but no correlation with maternal TC and cord HOMA-IR,TC(P>0.05)in the medical group,negatively correlated with TC,TG,FINS,HOMA-IR(P<0.05)but no correlation with FPG and cord blood indexes(P>0.05)in the insulin group.3)Placental Betatrophin mRNA and placental Betatrophin protein positively correlated with umbilical blood glucose,insulin,HOMA-IR and TG(P<0.05),but there was no correlation with maternal indexes and cord blood TC(P>0.05)in the medical group.There was no correlation between placental Betatrophin mRNA and placental Betatrophin protein with maternal and cord blood indexes(P>0.05)in the insulin group.4)The cord blood Betatrophin positively correlated with glucose,insulin,HOMA-IR and TG(P<0.05),but no correlation with TC(P>0.05)in the medical group,while in the insulin group,the cord blood Betatrophin positively correlated with glucose,insulin,HOMA-IR(P<0.05),but no correlation with TG,TC(P>0.05)5)The plasma Betatrophin,HbAl c and GSP were decreased after the treatment in both groups and the differences were statistically significant(P<0.05).The plasma Betatrophin positively correlated with GSP(P<0.05),but no correlation with HbA1c(P>0.05).Conclusion:1.Maternal Betatrophin may positively regulate glycolipid metabolism in GDM women treated by medical nutrition.After insulin treatment,this relationship changed2.In GDM,the regulatory relationship of maternal Betatrophin to the fetal glycolipid metabolism was different for different therapies,and was not affected by placenta.3.In GDM,the relationship between placental Betatrophin expression and fetal glycolipid metabolism was changed by maternal insulin therapy.4.In GDM,plasma Betatrophin may be an indicator for short-term monitoring and evaluation of glucose changes.