Study On The Role Of Adipokine Apelin And Chemerin In The Pathogenesis Of GDM

ObjectiveBy determining and comparing the change of adipokine apelin and chemerin in the serum of normal pregnant women, GIGT pregnant women and GDM pregnant women, the paper analyzes the relationship between adipokine apelin and chemerin and related metabolism and clinical biochemical indicators, and it also explores the roles of adipokine apelin and chemerin in the pathogenesis of insulin resistance and GDM in gestational women.MethodsGestational diabetes screening is given to the pregnant women of 24-28 weeks. Then further oral glucose tolerance test(OGTT)will be given to those who have abnormal screening results of 50 grams of glucose powder. According to the difference of venous blood glucose values at each time point the pregnant can be divided into three groups: normal group (NGT) 26 cases, impaired glucose tolerance group (GIGT) 20 cases, gestational diabetes mellitus group (GDM) 28 cases. According to the pregnancy body mass index the pregnant women can be divided into two groups: 34 patients of normal weight, overweight 40 cases. Then make a research on the pre-pregnancy weight and the economy condition of each family of all the pregnant women. Measuring height, weight, diastolic blood pressure (DBP), systolic blood pressure (SBP), body mass index (BMI) = weight (kg) / height (m2); taking cubital vein, using double antibody sandwich enzyme linked immunosorbent assay (ELISA) measure fasting serum adipokine apelin and chemerin, and apelin and chemerin 2 hours after load; also measuring all subjects triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), fasting serum insulin (FINS), 2 hours after glucose load blood glucose (2hBG), 2 hours after glucose load insulin (2hPINS);using homeostasis model assessment calculate the insulin resistance index(HOMA-IR),HOMA-IR=FBG×FINS/22.5;applying SPSSll.5 statistical software groups are compared and analyzed.Results(1) Apelin in serum of fasting and 2 hours after glucose load in the NGT group, GIGT group and the GDM group increased gradually [NGT:392±17pg/ml,452±21 pg/ml;GIGT:466±29pg/ml,571±39pg/ml;GDM:468±31pg/ml,575±40pg/ml],Apelin in serum of GIGT and GDM groups was higher than NGT group, and the difference was statistically significant(P <0.05); while the difference of GIGT and GDM group was not statistically significant (P> 0.05);Apelin in serum of fasting and 2 hours after glucose load in overweight group is higher than in normal weight group [overweight:479±42ug/L,582±39ug/L;normal weight group:397±31 ug/L,458±33ug/L, the difference was statistically significant (P<0.05)].(2) Chemerin content in serum of fasting and 2 hours after glucose load in the NGT group, GIGT group and the GDM group increased gradually [NGT: 58.8±19.2ug/L,66.8±21.2ug / L;GIGT:62.8±18.2ug/L,69.9±22.1ug/L; GDM:65.2±17.6ug / L, 72.8±23.1ug / L. The difference between the groups has no statistical significance (P> 0.05)]. Chemerin content in serum of fasting and 2 hours after glucose load in overweight group is obviously higher than in normal weight group [overweight:73.5±9.2ug/L,76.9±22.3ug/L;normal weight group:59.4±9.1ug/L, 65.9±9.3ug/L,and the difference was statistically significant (P<0.05)].(3) Serum insulin of fasting and two hours after the load in the three groups of the pregnant women respectively is [NGT:14.16±2.42uIU / L , 36.52±21.23uIU / L; GIGT: 21.86±3.87uIU / L, 57.23±39.58 uIU / L l; GDM: 19.08±3.65 uIU / L, 45.14±30.56 uIU / L . Pairwise comparison among the three groups, the differences were statistically significant (P <0.05).(4) Insulin resistance index (HOMA-IR) reflecting the insulin sensitivity index in NGT, GIGT and GDM three groups of pregnant women respectively is [2.85±0.48,3.71±0.92,3.98±0.76]. NGT group is lower than the other two groups. The difference was statistically significant (P <0.05), while the difference of GIGT and GDM was not statistically significant (P> 0.05).(5) Pearson linear correlation analysis showed: fasting apelin levels and HOMA-IR, pregnancy BMI, TC, LDL-C, FBG, FINS, chemerin were positively correlated (r = 0.58, P <0.01; r = 0.47, P <0.01; r = 0.35, P <0.01; r = 0.34, P <0.01; r = 0.32, P <0.05; r = 0.26, P <0.05; r = 0.35, P <0.05). Fasting Chemerin level and pregnancy BMI, HOMA-IR ,TG, LDL-C, FBG, FINS, 2hBG, 2hPINS were positively correlated (r = 0.68, P <0.01; r = 0.49, P <0.051;r = 0.46, P <0.01; r = 0.37, P <0.05 ; r = 0.32, P <0.05; r = 0.26, P <0.05; r = 0.19, P <0.05; r = 0.22,P <0.05).(6) Multiple linear stepwise regression analysis showed that HOMA-IR and Pregnancy BMI during pregnancy were independent factors that influence the apelin in serum. Pregnancy BMI and HOMA-IR were independent factors that influence the Chemerin in plasma.Conclusion(1) Adipokine apeline and chemerin in serum of gestational diabetes patients elevated, and apelin, chemerin and insulin resistance are closely related to the development.(2) Apelin, chemerin and HOMA-IR levels in the serum of pregnant women showed a positive correlation.(3) Apelin and chemerin in the development of the IR may be achieved by changing the insulin resistance index, and lowering the apelin and chemerin levels in serum of patients may become a new target for treatment of IR in the future.