Research Progress Of Plasminogen Activator Inhibitor One In Gestational Diabetes Mellitus

Objectives: (1)To explore the level of PAI-1 in plasma and the positive expression rate of fatty tissue in gestational diabetes mellitus (GDM) and to evaluate their correlation with GDM and insulin resistance(IR).(2)To investigate the correlation of the plasma PAI-1 level and the positive expression rate of fatty tissue in obese and non-obese GDM.Methods: (1)Common materials collected of those hospitalized and ready for birth-giving included age,family history of diabetes, height, weight, and computed body mass index (BMI); fasting blood-glucose (FBG) and fasting insulin (FINS)were tested; Insulin resistance index was evaluated by steady-state model.(2) Plasma PAI-1 level of 40 pregnant women of GDM (study group)and 40 normal subjects(control group) was measured by ELISA.(3) The expression of PAI-1 in fatty tissue of study group and control group was examined using immunohistochemistry . The two were divided into non-obese (BMI<28kg/m2)and obese ( BMI≥28kg/m2) groups.Results: (1)The average of plasma PAI-1 in GDM group was 335.25±30.81ng/ml, significantly higher than that (202.28±14.36ng/ml) in control group(P<0.01).(2)Plasma PAI-1 of two groups was positively correlated with BMI,FBG,FINS,andIR.The correlation coefficient of IR in GDM group was 0.763,higher than that (0.432) in control group.The correlation coefficient of IR in obese GDM group was 0.816, higher than that(0.725) in non-obese GDM group.(3)The average of plasma PAI-1 in obese GDM group was 400.89±45.69ng/ml,significantly higher than that(229.78±21.94ng/ml) in non-obese GDM group (P<0.01).(4)PAI-1, BMI, and GDM family history were included in terms of GDM-related multivariate Logistic regression analysis.(5)The rate of positive PAI-1 expression in fatty tissue was 37.5% in GDM group and 17.5% in control group, with the former significantly higher than the latter(P<0.05).(6) There was no significant difference between GDM groups with and without obesity in the expression of fatty PAI-1.Conclusions: (1)Plasma PAI-1 is positively correlated with IR, and the increase in plasma PAI-1 may lead to the rise in IR.(2)Plasma and fatty tissue may be involved in GDM,with the pregnant women of GDM having more serious IR simultaneously.(3)The level of plasma PAI-1 is closely related with those of FBG and FINS. The marked rise of PAI-1 level in obese pregnant women of GDM may be due to the co-effect of such metabolic disorders as hyperinsulinemia,hyperglycemia,and the secretion of fatty tissue into blood.(4)Fatty tissue also plays an important role in producing inflammation- inducing inflammation-inducing factor PAI-1.(5) PAI-1 may serve as an independent factor to predict the occurrence of GDM.