Study On The Correlations Of Adipocyte Fatty-acid Binding Protein And Gestational Diabetes Mellitus

ObjectiveTo study the expression of adipocyte fatty-acid binding protein A-FABP in placental tissues and serum of normal and diabetic pregnant women. The relationship among body weight, substances and the insulin resistance index was discussed, to lipid disorders and insulin resistance role of FABP4 in GDM, for to explain the pathogenesis and early diagnosis of GDM from FABP4.MethodsThe expression of FABP4 was detected in serum and placental tissues of diabetic pregnant women (GDM groups) and normal ones (control groups), which are respectively grouping to normal and overweight according to body weight, the with the application of enzyme-lingked immunosorbent assay(ELISA). The fasting blood glucose, insulin levels, triglyeride and total cholesterol were determined separately with glucose oxidase method and radioimmunoassay. The body mass indexes were gained from the body weight before pregnancy and delivery. The indexes of insulin resistance, insulin sensitivity index, (β-cell function, were calculated with homeostasis model (HOMA). All relevant information was statistical analyzed.Restult1. There was no statistical difference in age, gestational age, and blood pressure between two groups (P>0.05). Compare with the NGT normal group, all of FBG, triglyeride, total cholesterol and HOMAIR of the GDM normal group increased (P> 0.05), both HOMAISI and HOMA-B% was lower. In GDM pregnant women, BMI change value, FBG, FINS, triglycerides, HOMAIR in the overweight group were higher than normal group (P<0.05), HOMAISI is lower than the normal group (P <0.05).2. ELISA results:The sample hole of the GDM normal group was yellow; the GDM overweight group was dark yellow; the NGT normal group was pale yellow; the analysis with Standard microplate reader(450nm), the differences of the serum FABP4 concentrations between the three groups was statistically significant (Welch=9.663, P=0.001). 3. FABP4 mainly expressed in the cytoplasm of mature adipocytes, the protein expression in placenta of the GDM group was higher than NORMAL group. normal control group:FABP4 is not or weakly expressed in syncytiotrophoblast, a few expressed strong positive. GDM Group:most FABP4 in syncytiotroph the expressed strongly positive, especially in overweight GDM, brown yellow or brown can be seen on the edge of the placenta, occupying the entire trophoblast cells, even showed a continuous linear or can be connected to the nest-like distribution of pellets, few cells weakly expressed or not expressed. The differences of the compare of the placental tissue FABP4 between the three groups was statistically significant (χ2=17.278 P<0.01).Thereinto,the GDM normal group is higher than the NGT normal group(Z=3.147,P=0.002). The differences between the GDM normal group and the NGT overweight group was not statistically significant (Z= 1.007, P=0.314)4. The level of HOMA-IR was positively correlated with BMI, and the rs=0.705 (P=0.000).5. The expression of FABP4 concentrated in serum was negatively correlated with HOMA-IR, and the rs,=-0.146(P=0.265), The expression of FABP4 concentrated in placental tissue was positively correlated with HOMA-IR, and the rs=0.456 (P =0.000).Conclusions1. The FABP4 concentrated in serum and placental tissue of two GDM group were significantly increased than the NGT normal group, suggesting that FABP4 may have relationship with insulin resistance increased during pregnancy.2. The FABP4 expression in placental tissue of two GDM group was increased than the NGT normal group, and its expression is positively correlated with HOMA-IR, infer the degree of obesity associated with the increased of insulin resistance during pregnancy.3. HOMA-IR is positively correlated with progestational BMI, there is more serious insulin resistance in GDM patients than the normal pregnant women. It may be the main reason for the GDM, and adipocytokines may play an important role in the process of GDM.4. The increased levels of FABP4 is closely related to obesity and the process of gestational diabetes, but whether insulin signaling pathway involved in the regulation and the ability to find a FABP4 diagnostic cut points for the early diagnosis of gestational diabetes provide new targets. It still needs to continue in-depth basic research and clinical application of research extensively.