| Nowadays, there are a large number of researches about the pathogenesis of type 2 diabetes mellitus which is considerated as a complex disease that includes a lot of genes and environmental factors. However, the researches about the pathogenesis og gestational diabetes mellitus(GDM) are not so many. The nosogenesis of GDM, it is believed that because of the placental hormone and other insulin-resistant matter, the insulin sensitivity of the body is decreased, and all lead to physiological insulin resistance. The pregnant women who had limited secretion of insulin will suffer from GDM. However, the renewed notion believes that on the metabolic and endocrinological aspects, GDM is the decompensational state which show the overlap of chronic insulin-resistance and the physiological insulin-resistance in third trimester of pregnacy, and the deficiency of compensational insulin secretion which can not overcome IR. After Yang Q et al firstly found that RBP4 is in close relations with some marks of insulin resistance in mouse in 2005, there are many researches currently about the level of RBP4 in patients with type 2 diabetes mellitus and GDM. But there is no unanimous conclusion at present tiome. OBJECTIVE: To compare the level of serum RBP4, blood lipid profile, blood glucose and insulin in women with GDM and without GDM(NGDM). To probe the differences between women with GDM and NGDM, and the influencing factors.Method:81 follow-up patient in the first Affiliated Hospital of Chongqing medical university have been collected. The medical histories have been collected. A medical check-up and 2h-OGTT has been given for all. According to the ADA diagnosis standard of GDM in 2009, they have been divided into 2 groups which one was GDM group with 36 cases and the other was NGDM group with 45 cases. ELISA kit of RD company has been used to measure the serum level of RBP4 in all cases. At the same time, the serum level of blood fat, blood glucose and insulin have been measured, HOMA-IR has been calculated.Statistical evaluation was performed with SPSS software version 16.0 to compare the serum level of RBP4, blood lipid profile, blood glucose and insulin in women with GDM and NGDM. The significance level was set at P<0.05. Multiple linear regression model has been used, while RBP4 has been regarded as independent variable, blood lipid profile, blood glucose and insulin has been regarded as induced variables.Results:1. Women with gestational diabetes had lower level of RBP4 than controls(([28.38±22.60]vs[55.20±65.51] ng/L, P=0.013)] ng/L, P=0.013), but a higher BM(I[26.64±3.05]vs[25.05±2.81]kg/m2,P=0.017),HOMA-IR([2.27±1.26]vs[1.75±0.6],P=0.026)and HOMA-B(19.43±15.95VS 11.23±3.39, P<0.01). The multiple linear regression analysis showed that the level of RBP4 was not affected by HOMA-IR, but HDL-c(coefficient B=31.827,P=0.021),TC(coefficient B=-17.269,P=0.004),HOMA-B(coefficient B=2.419,P=0.016)in GDM group.Conclusion:Women with gestational diabetes who show obvious insulin resistance have higher HOMA-IR than women in the contrast group, but lower level of RBP4. Multiple linear regression shows that RBP4 can not been influenced by HOMA-IR, and it seems like that RBP4 is not a valuable marker for identification of the insulin-glucose homeostasis during pregnancy. |
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