Changes In Biomarkers Of Oxidative Stress And Their Clinical Significance In Gestational Diabetes Mellitus

Gestational diabetes mellitus(GDM)is defined as diabetes diagnosed after the first trimester of pregnancy that is not either type 1 or type 2 diabetes mellitus.We investigated changes in oxidative stress biomarkers and their relationship with pregnancy outcomes in patients with GDM to evaluate their clinical significance.The study included 2 groups of pregnant women(GDM and healthy controls).Oxidative stress biomarkers were evaluated by absorbance-based and immunohistochemical,assay.all patients’ pregnancy outcomes were tracked.In the GDM group,women were older,had a higher prepregnancy weight,a higher BMI value,delivered at earlier gestational weeks,and had higher rates of cesarean delivery,macrosomia,premature rupture of fetal membranes(PROM),and preterm birth as compared with the control group.Women with GDM showed increased levels of serum MDA,placental HO-1,Nrf2,NQO1 and reduced expression levels of serum GSH and SOD compared with control group.In the GDM group,MDA levels were negatively associated with prepregnancy weight,and SOD levels were positively correlated with neonatal birth weight.We found an intensive relationship between SOD content and preterm birth in the GDM group.Moreover,prepregnancy weight don’t associated with GSH and SOD levels.There is no significant difference between the level of MDA/GSH and neonatal birth weight as well as preterm birth.MDA,GSH,and SOD levels were not associated with an increased risk of cesarean delivery or PROM.This study indicates there is oxidative stress in GDM.and the changes in biomarkers we measured are associated with adverse pregnancy outcomes.This study may provide references and suggestions for better prevention and management of GDM pregnant women and prevention of adverse pregnancy outcomes.Part I.CHANGES IN SERUM BIOMARKERS OF OXIDATIVE STRESS IN GESTATIONAL DIABETES MELLITUSObjective: To investigated changes in serum oxidative stress biomarkers and their relationship with pregnancy outcomes in patients with GDM to evaluate their clinical significance.Methods: The study included 175 pregnant women,who were divided into 2 groups(93 GDM and 82 healthy controls).Oxidative stress biomarkers MDA,SOD,GSH were evaluated by absorbance-based assay,and all patients’ pregnancy outcomes were tracked.Results:(1)In the GDM group,women were older,had a higher prepregnancy weight,a higher BMI value,delivered at earlier gestational weeks,Women with GDM showed increased levels of MDA and reduced expression levels of GSH and SOD compared with control group.(2)In the GDM group,MDA levels were negatively associated with prepregnancy weight,and SOD levels were positively correlated with neonatal birth weight.We found an intensive relationship between SOD content and preterm birth in the GDM group.Moreover,prepregnancy weights don’t associate with GSH and SOD levels.There is no significant difference between the level of MDA/GSH and neonatal birth weight as well as preterm birth.MDA,GSH,and SOD levels were not associated with an increased risk of cesarean delivery or PROM.Conclusion: This study indicates there is oxidative stress in GDM.And the changes in biomarkers we measured are associated with adverse pregnancy outcomes.Part II.CHANGES IN PLACENTAL BIOMARKERS OF OXIDATIVE STRESS IN GESTATIONAL DIABETES MELLITUSObjective: To investigated changes in placental oxidative stress biomarkers and their relationship with GDM to evaluate their clinical significance.Methods: We randomly selected 10 placental tissues(5 samples from the GDM group and 5 from the control group)from par I for observing HO-1,Nrf2,NQO1,AKR1C1 and SOD expression in placenta by IHC(immunohistochemical)assay.Results:(1)IHC staining showed that all the oxidative stress markers were expressed in placental of both normal pregnancy and diabetic pregnancy;they were located in the cytoplasm of the trophoblast cells.(2)Significantly higher HO-1,Nrf2 and NQO1 protein expression were observed in placenta samples from patients suffering from GDM,while SOD levels were decreased in the GDM group compared with the normal group.Conclusion: The increase of placenta HO-1,Nrf2,NQO1 expression level may be antagonizing oxidative stress ensures blood flow to the placenta for the protection of the body and the fetus.