The Role Of HbA1c And TNF-α In GDM

PartⅠThe role of HbA1c between in Screening test for GDM and macrosomia Objective: Through studying 457pregnant women,We can investigate the significance of using glycosylated hemoglobin A1c (HbA1c) as a screening test for gestational diabetes mellitus (GDM), screening the pregnant women with high risks during the first trimester of pregnancy and correltion with HbA1c and fetal weight . Methods: We compared the HbA_1c test with fasting plasma glucose and 50-g oral glucose challenge test (GCT) in testing 457pregnant women.and record their datum about ages, the body weigh before pregnancy, BIM before pregnancy,the family history of GDM and fetal weight. Results:For early detection of GDM, it was important to screen women during the first trimester pregnancy. The number of GDM women was higher than that of control group in ages;body weigh before pregnancy; BIM before pregnancy and family history of GDM (p<0.05). At the level of 5.15% HbA1c showed good 95.5% of sensitivity and good 84.1% of specificity. At the level of 4.8mmol/L fasting plasma glucose showed bad 72.7% of sensitivity and 89% of specificity. At no GDM women, there was no signifinance between HbA1C and fetal weight( P>0.05) ,in GDM women, there was prominent relationship between between HbA1C and fetal weighty( P<0.05) . Conclusion: It is very important to develop a screening test that can be administered during the first trimester of pregnancy. Early detection of GDM is the preeminent way to control the disease and prevent major complications. HbAlc is very possible as a method for detecting GDM . In GDM women group, the value of HbA1C was correlative to neonatal weigh, but there was no relationship in no GDM group. PartⅡSignificance of Serum Level of Tumor Necrosis Factor in gestational diabetes mellitus Objective:to investigate the significance of serum Level of tumor necrosis factor in gestational diabetes mellitus(GDM). Methods: By the method of ELISA,the change of serum tumor necrosis factor-alpha(TNF-α) was surveyed.By DiaSTAT HbA1c Analyzer, glycosylated hemoglobin A1c (HbA1c) was determined . Results:The results showed that the level of TNF-αin GDM group was significantly higher than the normal control group (p<0.05),There was a positive correlaton between the TNF-αlevel and HbA1c(r=0.677,p=0.00) and no correlaton between the TNF-αlevel and ages or BIM in GDM group. There was no correlaton between the level of TNF-αand HbA1c ,ages or BIM in the normal control group. Conclusion: We concluded that gestational diabetes mellitus with higher TNF-αlevel in serum is correlated with the occurrence and development of gestational diabetes mellitus.It led high plasma glucose through insulin resisting(IR).High plasma glucose brought much TNF-α.When function of βcell in pancreas is insufficient,GDM would occur.