Study On The Relationship Between The Sex Hormonebinding Globulin And Gestational Diabetes Mellitus

PrefaceSex hormone-binding globulin ( SHBG) , a kind of glucoprotein, is produced by liver, which can differentially combine with sex hormone, participate in its transport, and modify the concentration of bioactive sex hormone. Its level is regulated by many hormones such as sex hormone, thyroid, prolactin, insulin and so on . It's showed in present study that SHBG is a risk factor of diabetes mellitus, while the research about its function in the coming on and development of gestational diabetes mellitus( GDM) is a fat lot. Our objective; (1) To Measure the change of serum SHBG concentration in pregnancy between GDM and normal pregnant women. (2) To compare the change of serum SHBG concentration in normal pregnant women ,abnormity of glucose challenge test, abnormity of glucose tolerance and GDM pregnant women. (3) To discuss the relativity a-mong SHBG with sex hormone and the risk factor of GDM such as glucose , BMI,TG,TC, thereby to find a sensitive index to predict the development and progress of GDM.Methods1. experimental groupingThe experiment includes three groups: 1) diabetic pregnant women in dif-ferent gestational age 64 cases (includes the women of post partum 8 cases) , normal pregnant women 69 cases (includes the women of post partum 9 cases) and no pregnant women 8 cases; 2) 32 -34 gestational age: GCT abnormal pregnant women 12 cases, OGTT (oral glucose tolerance test) abnormal pregnant women 12 cases, diabetic pregnant women 12 cases, normal pregnant women 13 cases; 3) 24 ~34 gestational age diabetic pregnant women 32 cases and normal pregnant women 37 cases.2. collecting sampleWe collect 2 tube(2ml) of the blood of pregnant women in obstetric ambulant clinic and ward,one for measuring the fasting glucose,the other being at rest and acentried for 1 hour,and then being kept in -40^C refrigeratory ,and the clinic data of patients ( age N avoirdupois ? stature % pregnant week N pressure > the history of deliveryxthe history of family should be collected as well).3. index measuremeasure serum SHBG concentration by ELIsa.Measure the fasting glucose by the method of glucose oxidation enzyme.Measure TC and TG by the method of enzyme.Measure E2 and T by the method of chemistric shine.4. statistics analysisthe data is analysed by SPSS1O. 0 statistic software, the compare between the two group adopt t-test, the relation of two variables adopt beeline correlation analysis.Result1. The SHBG concentration in normal pregnancy was significantly higher compared with no pregnancy, and it slowly increased with the increasing of gestational age to reach the top at about 24 ~ 28 pregnant age , then slowly reduced to the lowest level at about 28 ~ 32 pregnant age , and increased again up to the top at about 32 ~ 36 pregnant age , and reduced to the level of pre-gestation after delivery. The SHBG concentration in women with GDM, especially in the groupbefore 24 gestational age and post partum, was significantly lower than that in normal pregnant women(P <0.01).2. Among normal pregnant women s abnormity of glucose challenge test % abnormity of glucose tolerance and GDM pregnant women, the SHBG concentration in women with GDM was significantly lower than other groups ( P < 0. 05) ; the SHBG concentration in normal pregnant women was significantly higher than other groups ( P < 0. 05 ) ; the SHBG concentration in OGTT abnormal pregnant women was similarly compared with that of GCT abnormal pregnant women ( P > 0.05).3. The level of triglyceride x testosterone and FBG was significantly higher than that in control group ( P <0. 01) , the SHBG concentration was lower ( P < 0.01) , while estradiol was similar, correlation analysis showed that SHBG was negatively correlated with the fasting glucose XBMI and triglyceride in the group of GDM, While SHBG was negatively correlated with testosterone in the normol control group.Conclusion1. The SHBG concentration in normal pregnancy was significantly higher compared with no pregnancy, and it slowly increased with the increasing of gestational age, and reduced to the level of pre-gestation after delivery. The SHBG concentration in women with gestational diabetes mellitus was significantly lower during the whole pregnant period, gestational diabetes mellitus could be predicted by measuring the SHBG concentration in early pregnancy, the level of SHBG post partum was very important to judge GDM.2. The SHBG concentration was significantly reduced in only GCT abnormal pregnant women and glucose tolerance abnormal pregnant women. By the determination of SHBG could predict the latent group for GDM and judge the coming on and development of GDM and its seriouse degree.3. The level of SHBG was mainly regulated by sex hormone in normal pregnant women, and it was the main action that high insulinemia suppress SHBG secretion in GDM women.4. The low level of SHBG tightly related with obesity and high serum lipids.