| BackgroundDiabetes is a complex disease of genetic heterogeneity induced by polygenic inheritance and associated with autoimmune disorder. Several studies have highlighted that typel and type2 diabetes are associated with the Sulfonylurea Receptor-1 (SUR1) gene. Some investigators have paid attention to whether gestational diabetes mellitus (GDM) has the same genesis as typel and type2 diabetes. There was only one report that correlated GDM with SUR1 alleles polymorphism, and in Asia the studies assessing the association between the SUR1 gene and GDM are still to be done.ObjectiveThis study was to investigate allelic frequency of SUR1 in GDM women of Han ethnicity in Tianjin in order to determine if there is a specific allele of SUR1associated with GDM susceptibility. In addition, the study was designed to assess the relationships between the SUR1 allele, body mass index (BMI) and secretion of insulin. The purpose of this study was to explore the etiological characteristic form SUR1 gene alleles polymorphism in order to establish a foundation forfurther investigating the pathogenesis of GDM. MethodsThirty-five GDM women were enrolled as the study group, 35 normally pregnant women and 35 with type 2 diabetes were selected as control groups, and all pregnant women were primiparas with single fetus. The possibility of hypertension and the other chronic diseases were excluded in all cases. One hundred married and childbearing unrelated female patient with diabetes were investigated by questionnaire. Five milliliters venous bloods were taken from all women in the three groups. Genomic DNA was extracted from peripheral venous blood. By using PCR-RFLP, we detected the distribution of SUR1 alleles frequency in all individuals of three groups.Result1. There was significantly increased "c"alleles frequency of SUR1 in GDM andT2DM women compared with normal pregnancy. (70.0 % vs 52.9% and 71.4% vs 52.9%, P<0.05). We observed an increase of the "cc" gene in GDM andT2DM women, but the statistical differences compared with the normallypregnant group were not significant(both51.4% vs 28.6%, P>0.05 ).2. There was significantly increased "A" alleles frequency of SUR1 in GDM andT2DM women compared with normal pregnancy. (41.4% vs 24.3 % and 44.3%vs 24.3 %, P<0.05). There was an increase of the "AA" gene in GDM andT2DM women, but the statistical differences compared with the normallypregnant group were not significant (20.0% vs 5.7% and 22.9% vs 5.7%,P>0.05 ) .3. In GDM group, the patients carrying the "cc" genotype had a higher BMI (29. 29 5. 62 vs 25. 27 4. 62kg/m2, P<0.05; 29. 29 5. 62 vs 24. 28 1. 75kg/m2 , P<0.01) , fasting insulin (INSO) (14.99 8.75 vs 10.17 6. 28m U/L, P<0.01; 14. 99 8. 75 vs 10. 02 2. 33mU/L, P<0.01) and 2h insulin levels(INSO120) (40. 23 12.12 vs 32. 74 10. 56mU/L, P<0.05; 40.23 12.12 vs 28.80 8.38 mU/L, P<0.05) compared with that in carriers of other genotypes ("ct", "tt"). Those carrying the "cc" genotype had a significantly lower insulin sensitivity [HOMA(R,)] (3. 98 2. 54 vs 2. 61 1. 88, P<0.05; ) compared with that in carriers of "ct", but not compared with the "tt" genotype(3.98 2.54 vs 2. 60 1.02, P>0.05) .4. In the GDM group, those carrying the "AA" genotype had a higher fasting insulin (INSO) compared with that in carriers of other genotypes ("AG" "GG")(15.48 3.25 vs 12. 12 4. 56mU/L, P<0.05; 15. 48 3. 25 vs 11.51 4. 86mU/L, P<0.05) .However the statistical difference of 2h insulin levels (INSO 120) , insulin sensitivity [HOMA(Ri)] and BMI were not significant.5. Logistic regression analysis showed there was a relationship between SURl "cc" and the more serious type of GDM. (P=0.005, RR=25.128)6. There were 24 (24%) patients suspected of previous GDM in 100 married and childbearing diabetic women, 1 (4.17%) of them developed overt diabetes within 0-5 years after delivery, 4 (16.67%) within 5-10 years, 8 (33.33%) within 10-20 years, 11 (45.83% ) after more than 20... |
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