| Objective:Gestational diabetes mellitus(GDM)is defined as carbohydrate intolerance of varying severity with onset or first recognition during pregnancy.In recent years,as medical diagnostic technology and living standard progress,the morbidity of GDM presents an annual rising trend.At present,diabetes mellitus is considered as a polygenic inherited disease.GDM is a special type of diabetes, multiple genes have a impact on GDM.Some sites in HLA gene may have certain connection to the susceptibility of GDM.However,there is no definitive academic opinion on the connection between HLA gene and GDM.We investigate the association between polymorphism of HLA-DQA1 and susceptibility of gestational diabetes mellitus in Han ethnic of Guangxi,and the association between polymorphism of HLA-DQA1 and the blood glucose of the GDM pregnant women and the blood glucose,weights,Apgar scores of their newborns.Methods:This study enrolled 50 cases of GDM and 50 cases of normal pregnant women in the First affiliated Hospital of Guangxi medical university during October,2006 to April,2007,excluded diseases correlated with HLA gene. GDM was diagnosed by WHO standard.PCR-SSP gene typing technique was used to detect HLA-DQA1 alleles.Record the blood glucose of the GDM pregnant women and the blood glucose,weights,Apgar scores of their newborns.Results:It was observed that gene frequency of HLA-DQA1~*0501 increased in GDM group compared with control group(30%vs 14.0%,P=0.006).OR is 2.633.We also observed that the gene frequencies of HLA-DQA1~*0101,0104, 0201 and 0601 gene were incresed in GDM group,but have no significant difference(9.0%vs 6.0%,11.0%vs 10.0%,3.0%vs 2.0%,6.0%vs 5.0%, P＞0.05).The gene frequencies of HLA-DQA1~*0102,0103,0301,0302 and 0401 were decreased in GDM group,but also have no significant difference (20.0%vs 28.0%,3.0%vs 8.0%,9.0%vs 13%,0.0%vs 2.0%,9.0%vs 12.0%, P＞0.05).19 GDM patiens(38%)need insulin therapy.The blood glucose of 47 GDM patiens(94%)control well.In GDM group,the postpartum blood glucose decresed compared with the antepartum(5.16±0.83mmol/L vs 6.26±0.76mmol/L,P＜0.05).The incidence of bad outcomes in previous gestation and delivery,and the familiy history of high blood pressure and diabetes mellitus in GDM group was higher than the control group(18.0%vs 2.0%,12.0%vs 2.0%,28.0%vs 0.0%,P＜0.05).The weight of newborns of GDM group much higher than control group(3341.6±329.7g vs 3169.4±497.7g, P＜0.05).And the blood glucose of newborn lower than control group(3.16±0.83 mmol/L vs 5.04±1.63mmol/L,P＜0.05).The median of Apgar score in two groups were both 10,have no significant difference(P＞0.05).Large for date infant was two in GDM group(4.0%),while one in control group(2.0%, P＞0.05).One in GDM group had neonatal hypoglycemia(2.0%),none in control group(P＞0.05).Apnoea neonatorum was two in GDM group(4.0%),and two in control group(4.0%),also have no significant difference(P＞0.05).Divided GDM group into two groups,one group have HLA-DQA1~*0501, another didn't have.The postpartum blood glucose and the antepartum in two groups have no significant difference(6.35±0.85 mmol/L vs 6.17±0.68 mmol/L, 5.42±0.75mmol/L vs 5.49±0.91 mmol/L,P＞0.05).The incidence of bad outcomes during previous gestation and delivery,the familiy history of high blood pressure and diabetes mellitus,needed insulin to cure have no difference (26.1%vs 11.1%,4.3%vs 18.5%,39.1%vs 18.5%,37.0%vs 39.1%,P＞0.05). The weight,blood glucose and the Apgar score of newborn in two groups also have no significant difference(3366.9±346.7g vs 3320.0±319.7g,3.28±0.83 mmol/L vs 3.01±0.84 mmol/L,10 vs 10,P＞0.05). Conclusions:Alleles HLA-DQA1~*0501 may be the susceptible gene of GDM in Han ethnic of Guangxi,but the protective gene of GDM is still not found.The association between HLA-DQA1~*0501 and the glucose of pregnant women,the weight,blood glucose and Apgar score of newborns is also not found. |
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