| Gestational diabetes mellitus(GDM) is one of the major metabolic disorders of pregnancy and influents the mother and the fetus. During GDM pregnancy, the metabolism of mother is changed and the level of blood glucose is out of control.Through the placenta,the hyperglyconemia of the GDM mother stimulates fetus to increase insulin secretion.This process results in the development abnormality of fetus. But because the mechanism is unclear,we speculate that maybe correlated with insulin resistance(IR).Adiponectin,a newly discovered adipocytokines,regulates metabolism balance and energy homeostasis. It is considered that adiponectin is an important protecting factor of insulin resistance and metabolic syndrome.Adiponectin is also strongly linked to GDM.Because several studies have found that the level of serum adiponectin in GDM pregnant women were low,it suggests that adiponectin is involved in the development of GDM.However researchers discovered that adipoectin was also present in circulation of fetus and the effects of adiponectin on insulin resistance and β-oxidation of fats were concerned with growth and development in utero.So we hypothesize that adiponectin regulates energy homeostasis and growth and development of fetus.But it is unkown whether the serum levels of adiponectin of GDM mother and offspring is correlated with the metabolism of mother and the development of fetus.Whether is there the expression of adiponectin inplacenta, a ligament between mother and offspring?And whether does the adiponectin from placenta influent the GDM mother and fetus?In this study we aimed to determine serum adiponectin levels of gestational diabetus mellitus mother and newborn and adiponectin expression in placenta, analyse the relationship between adiponectin and the metabolism of GDM mothers and their offsprings and also dicuss the link between the expression of adiponectin in placenta and the growth and development of fetus.Two-part study is carried out.Part one: Study of the serum adiponectin levels of GDM mothers andoffspringsObjective: To investigate the relationship between serum adiponectin leveland insulin resistance(IR),body mass index(BMI) in GDM mother andoffspring,elucidate the role of adiponectin in development of GDM,discusscorrelation of serum adiponectin between GDM mother and offspring andprovide theoretical groundwork to clinic treatment of GDM.Methods: By using enzyme linked immunosorbent assay(ELISA) andradioimmunoassay(RIA) methods,the fasting levels of serum adiponectin andinsulin were measured in 30 normal pregnancy mothers and neonates,26GDM pregnancy mothers and neonates.Simultaneously we assayed bloodglucose,weight and height of mothers and neonates,calculated HOMA-IR andBMI.Results: (1)The serum adiponectin level of GDM mothers and neonates was significantly less than that of controls(P<0.05).(2) The serum adiponectin levels of mothers were unrelated with that of neonates,but were negatively correlated with IR and BMI of mothers.And the serum adiponectin levels of neonates were also negatively correlated with insulin resistance and RI of neonates.Conclutions: Because serum adiponectin levels of GDM mother and offspring obviously dropped and related with IR and the mass of fats,adiponectin may involve the development of GDM and growth of interuterus.In base of irrelevance of serum adiponectin levels between mother and offspring,it is possible that adiponectin of fetus isn't completely derived from maternal circulation,maybe partly from placenta or itself.Part two: Study of the expression of adiponectin in placenta of GDMmotherObjective: To study the expression of adiponectin gene and protein inplacenta of GDM mother,investigate the change of adiponectin expressionunder such pathological state as GDM,dicuss the relationship between theexpression of adiponectin in placenta and IR,BMI,interuterus growthabnormality of fetus with GDM mother.Methods: The adiponectin mRNA expression levels in placenta of 26 casesmothers with gestational diabetes mellitus(GDM) and 30 cases normal... |
PDF Full Text Request