J-Y Li1, G-M Wu, Z Hou, Y-M Cao. 1. Obstetrical Department 3, Hebei Cangzhou Central Hospital, Hebei, China. caoyanmin1968@126.com.
Abstract
OBJECTIVE: In this study, the changes of insulin resistance (IR) and pancreatic β-cell function in GDM patients were observed, changes of CTRP3 level in fasting serum and relationships with plasma glucose (PG) and pancreatic β-cell function were explored at the same time, and the correlation between serum CTRP3 and body mass index (BMI) was preliminarily discussed, providing a new way to identify the pathogenesis of GDM. PATIENTS AND METHODS: Data of women from 24 to 28 weeks of pregnancy were collected. 100 women were selected to form gestational diabetes mellitus (GDM) group and another 100 women were chosen to constitute normal glucose tolerance (NGT) group according to the results of oral glucose tolerance test (OGTT). They were divided into GDM overweight/obesity (GDM + OW) group, GDM non-overweight/obesity (GDM + NW) group, simple overweight (OW) group and normal body weight (NW) group, according to whether the progestational body mass index (BMI) was higher than 24 kg/m2 before pregnancy. General information of all subjects, for example, age, last menstrual period, parity, diet, weight and height, were collected, and blood samples were taken from all subjects for use in detections of total cholesterol (TC), triglyceride (TG), very low-density lipoprotein (VLDL), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and serum C1q/tumor necrosis factor-related protein-3 (CTRP3). RESULTS: The levels of FPG, 1 h PG, 2 h PG, fasting CP (FCP), fasting insulin (FINS), homeostasis model assessment of IR (HOMA-IR), TG and VLDL-C in the GDM group, were significantly higher than those in the NGT group. TC and LDL-C in the GDM group were greater than those in the NGT group. Compared with that in the NGT group, homeostasis model assessment of β (HOMA-β) index was lower in the GDM group. From the NGT group to the GDM group, FPG, 1 h PG, 2 h PG, FINS and FCP had rising tendencies, and the differences were of statistical significance. Pearson correlation analysis indicated that HOMA-IR was positively correlated with pre-pregnancy BMI, FPG, 2 h PG, FINS, 1 h INS, 2 h INS, FCP, 1 h CP and 2 h CP in the GDM group, HOMA-β was negatively related to FPG. In the NGT group, there was a positive correlation between HOMA-IR and pre-pregnancy BMI. The level of CTRP3 in fasting serum of the GDM group was distinctly lower than that of the NGT group. Pearson correlation analysis revealed that in the GDM group, fasting serum CTRP3 had positive correlations with HOMA-β and HDL-C, but negatively associated with pre-pregnancy BMI, FPG, 1 h PG, 2 h PG, FCP, HOMA-IR, TG and VLDL-C. In the NGT group, the fasting serum CTRP3 was negatively correlated with pre-pregnancy BMI. Multiple linear stepwise regression analysis showed FPG was an independent influencing factor for fasting serum CTRP3. CONCLUSIONS: With the increase of FPG, the progression of GDM IR patients is increased, and pancreatic β-cell function progressively declines. The decrease of CTRP3 level in fasting serum in GDM patients plays a metabolic role in the pathogenesis of GDM.
OBJECTIVE: In this study, the changes of insulin resistance (IR) and pancreatic β-cell function in GDM patients were observed, changes of CTRP3 level in fasting serum and relationships with plasma glucose (PG) and pancreatic β-cell function were explored at the same time, and the correlation between serum CTRP3 and body mass index (BMI) was preliminarily discussed, providing a new way to identify the pathogenesis of GDM. PATIENTS AND METHODS: Data of women from 24 to 28 weeks of pregnancy were collected. 100 women were selected to form gestational diabetes mellitus (GDM) group and another 100 women were chosen to constitute normal glucose tolerance (NGT) group according to the results of oral glucose tolerance test (OGTT). They were divided into GDM overweight/obesity (GDM + OW) group, GDM non-overweight/obesity (GDM + NW) group, simple overweight (OW) group and normal body weight (NW) group, according to whether the progestational body mass index (BMI) was higher than 24 kg/m2 before pregnancy. General information of all subjects, for example, age, last menstrual period, parity, diet, weight and height, were collected, and blood samples were taken from all subjects for use in detections of total cholesterol (TC), triglyceride (TG), very low-density lipoprotein (VLDL), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and serum C1q/tumor necrosis factor-related protein-3 (CTRP3). RESULTS: The levels of FPG, 1 h PG, 2 h PG, fasting CP (FCP), fasting insulin (FINS), homeostasis model assessment of IR (HOMA-IR), TG and VLDL-C in the GDM group, were significantly higher than those in the NGT group. TC and LDL-C in the GDM group were greater than those in the NGT group. Compared with that in the NGT group, homeostasis model assessment of β (HOMA-β) index was lower in the GDM group. From the NGT group to the GDM group, FPG, 1 h PG, 2 h PG, FINS and FCP had rising tendencies, and the differences were of statistical significance. Pearson correlation analysis indicated that HOMA-IR was positively correlated with pre-pregnancy BMI, FPG, 2 h PG, FINS, 1 h INS, 2 h INS, FCP, 1 h CP and 2 h CP in the GDM group, HOMA-β was negatively related to FPG. In the NGT group, there was a positive correlation between HOMA-IR and pre-pregnancy BMI. The level of CTRP3 in fasting serum of the GDM group was distinctly lower than that of the NGT group. Pearson correlation analysis revealed that in the GDM group, fasting serum CTRP3 had positive correlations with HOMA-β and HDL-C, but negatively associated with pre-pregnancy BMI, FPG, 1 h PG, 2 h PG, FCP, HOMA-IR, TG and VLDL-C. In the NGT group, the fasting serum CTRP3 was negatively correlated with pre-pregnancy BMI. Multiple linear stepwise regression analysis showed FPG was an independent influencing factor for fasting serum CTRP3. CONCLUSIONS: With the increase of FPG, the progression of GDM IR patients is increased, and pancreatic β-cell function progressively declines. The decrease of CTRP3 level in fasting serum in GDM patients plays a metabolic role in the pathogenesis of GDM.