| PrefaceGestational diabetes mellitus ( GDM) is a familiar syndrome during pregnancy , an it is badly threatening pregnant women's and their babies' healthy. Recent researches find that the patients with GDM is more severity in insulin resistance (IR) than normal pregnancy women. Sex hormone bingding globulin (SHBG) may be a group of substance which related to IR. And,insulin is important for regulating the metabolize of SHBG. This test first used ELISA means to detect the change of the SHBG concentration in the serum of pregnancy women in different groups and after only diet controlled group and the serum of new borns' umbilical cord. We determine the SHBG ,FIns and IR of all the specimens in order to probe into the rules of these indexs which change in the serum of GDM and after only diet controlled group and their new borns. Also,we want to know how these indexs affect the new borns' grow.Method1. Subjects: Pregnancy women who were definitely diagnosised as GDM and simply diet controlled and their newborns were studied (1),(2) and (3), pregnancy women who were no high risk for GDM and without any complications and their newborns as control, matched for age , gestational age, body weightand height.2. Specimen collection: Two groups had normal diet 3 days before withdrawn. After fasting 10 - 12hours,two tubesof 2ml blood were withdrawn from el-bow vein. One tube was used to test blood glucose, another was centrifuged after 1 hour. The serum samples were stored at 20℃ until assay. The cord blood was withdrawn from cord vein immediately after delivery of late pregnancy and what were delt with their mothers'.3. counting: FBG were measured by glucose - oxidase assay, Fins byECL (Electrochemical luminesecne) and SHBG by ELISA. All the specimens were detected at the same time.4. Statistical analysis; All data was assayed by SPSS for windows 11.2 and presented as medians with ranges. Sample mean were compared with Student t test. Correlation was calculated by the spearman rank correlation. A P value <0. 05 was considered significant.Result1. The SHBG levels of materal blood in GDM groups were significantly lower than that in the control group( p <0.01) ; and the levels of Fins and IR were significantly higher than those in the control group( p <0. 01) . The level of SHBG was decreased with the increasing of gestational age, there was a negative correlation between SHBG and FIns,IR. FIns and IR have positive correlation in the GDM group.2. According to the detection of SHBG in maternal blood and maternal blood after simply diet controlled , we can find that the SHBG levels were decreased in GDM group and SHBG levels were increasing after only diet controlled. We can find that blood glucose is decreasing after diet control .3. The SHBG levels of cord blood in GDM groups were significantly lower than that in the control group and the level of Ins higner than control groups. And concentrition of FBG( p < 0. 01) . We can make a conclusion that there was a negative correlation between SHBG and body weight of newborns, also between SHBG and Fins.Discussion1. The relationship of SHBG and IR in gestational diabetes mellitus1. 1 Women are in a state of insulin resistance when during pregnancy. Whether the pregnancy women are change into GDM or not is determined by the relation of IR and the capacity of insullin secretion. But the relation of two need more researches. In GDM patient insulin resistance is higher than normal pregnancy women, it exceeds physiological insulin resistance in late pregnancy. Insulin level is increased when pregnanced, this is suppressed the secretion of SHBG. It disturbs the sex hormone' s level in blood, baffles the metabolize of glucose and fat. Our test suggest that SHBG levels in GDM are significantly lower than control group and FBG,FIns,IRare higher than control group. SHBG levels increase with the gestational age. especially at 32 week, it is the lowest. Fins and IR are obvious increasing with gestatinal age, The two level is almost parallel, there are positive correlation between them,and there are negative correlation between SHBG and FIns. IR. So, SHBG is correlation with GDM and IR .1.2 The alteration of GDM after interventional therapyReaching and maintaining normal blood glucose are the key of GDM therapy , also are important part of decreasing the morbidity and mortatity of maternal and perinatal. Diet control physidal therapeutics and insulin treatment can significantly decline complicaton of maternal and perinatal. Form this experiment we can conclude that simply diet control can make some index change. So , it show that SHBG may be a index to judge the curative effect of GDM . At the same time , it also approve that simply diet control is the best therapy for GDM.2. Detect the SHBG concentration in the serum of new borns' umbilical cord.Our test suggest: SHBG level of cord blood is lower in GDM groups than in the normal groups. Fins level is higher in the GDM groups than in normal groups . SHBG is negative with new born body weight. And they are all macrosomia except one case in GDM group. This show that SHBG is closed to young fat,is also a high risk of DM.
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