The Relationships Among The Expression Levels Of Blood Glucose,glycosylated Serum Protein,glycosylated Hemoglobina1c, CD106and The Birth Weight Of Newborns In Gestational Diabetes Mellitus Patients

Objective: In recent years, with the improvement of people's living leveland the popularity of antenatal examination, the incidence of gestationaldiabetes mellitus(GDM) has showed a rising trend. It has been reported thatthe incidence of GDM has risen from2.9%to8.8%in developing countries.The risk of maternal and fetal complications such as preeclampsia,genitourinary tract infections, polyhydramnios, shoulder dystocia,birth trauma,postpartum hemorrhage and fetal malformations, fetal death, stillbirth, fetalmacrosomia, neonatal respiratory distress syndrome, hypoglycemia,hypocalcemia, hypomagnesemia has greatly increased in GDM women,whichdoes great harm to mothers and infants, and the risk of GDM women and theiroffsprings suffer type2diabetes mellitus has significantly increased.So thestudy on GDM has gradually become a hot spot of domestic obstetricaldepartment and endocrinology department. Blood sugar level at some time isreflected by the measure of blood glucose. Fasting plasma glucose(FPG) ismeasured commonly in clinical; The average level of blood sugar in the pasttwo to three weeks is reflected by the measure of glycosylated serumprotein(GSP); The average level of blood sugar in the past two to three monthsis reflected by the measure of Glycosylated Hemoglobin a1c(HbA1c).CD106is also called vascular cell adhesion molecule-1,the abnormal expressionreflects the disfunction of vascular endothelial cell. Now we think that thehigh glucose during pregnancy could cause the damage of vascular endothelialcell by forming glycation end products through direct role,increasing theexpression of CD106.This study discussed the correlations among them andthe birth weight in GDM patients by measuring the levels in blood.Aimed at investigating whether the incidence of fetal macrosomia could be reduced ornot if appropriate measures were taken timely during the management ofGDM, and to reduce birth trauma and cesarean rate, to get a betterunderstanding of the immediate and long-term effects of GDM on pregnantwomen and newborns, and to strengthen the awareness of pre-pregnancycounseling and pregnancy management.Methods:1Chose study subjects: According to diagnostic criteria for Diabetes ofAmerican diabetes association (ADA) in2011, chose20gestational diabetesmellitus pregnant women and their newborns from obstetrical department ofThird Hospital of Hebei Medical University, The Second Hospital of HebeiMedical University, Bethune International Peace Hospital, Hebei ProvincialPeople's Hospital from March2011to October2011, and20normal pregnantwomen and their newborns at the same time. Both groups excluded the othercomplications during pregnancy and the GDM women were given just dietand exercise therapy. There were no statistical differences in age, gestationalweeks, weight, height of pregnant women.2Experimental methods:Extracted fasting antecubital venous blood5mlfrom pregnant women after they were admitted to hospital to theanticoagulation tube,placed two hours at room temperature, collected serumafter it was centrifuged with the rotation speed3000r. min-1for15minutes,then stored at-80℃,all serum samples avoided hemolysis andrepeated freezing and thawing. Blood glucose was measured using GlucoseOxidase, HbA1c was measured using Reversed Phase Cation ExchangeChromatography. The serum concentrations of GSP, CD106of GDM womenwere measured using Enzyme-Linked Immunosorbent Assay(ELISA);Recorded the birth weight by electronic scale.3Statistical analysis:Analysis was done using the SPSS Base13.0statistical package,and all values were presented as the mean±standarddeviation(x±s).Differences between variables in two groups were tested usingIndependent-Samples T Test.Correlations between variables were analyzed using linear correlation. P values less than0.05were considered significant.Results:1FPG, GSP,HbA1c, CD106and the birth weight of Newborns in GDMgroup were significantly higher than those in normal pregnancy group, andthere were statistically differences between two groups(P＜0.01).2Correlation analysis2.1GDM group2.1.1There were linear positive correlations between the birth weight ofnewborns and the indexes of FPG, GSP, HbA1c and CD106respectively inGDM group(r=0.896P＜0.01;r=0.462P＜0.05;r=0.464P＜0.05;r=0.952P＜0.01).2.1.2There were linear positive correlations between FPG and theindexes of GSP,HbA1c,CD106respectively in GDM group(r=0.484P＜0.05;r=0.471P＜0.05；r=0.953P＜0.01)；2.1.3There were linear positive correlations between GSP and the indexesof HbA1c,CD106respectively in GDM group(r=0.596P＜0.01;r=0.504P＜0.05)；2.1.4There was a linear positive correlation between HbA1c and CD106in GDM group(r=0.496P＜0.05).2.2Normal pregnancy group2.2.1There were no correlations between newborn weight and the levelsof FPG, GSP, HbA1c or CD106respectively in normal pregnancy group(P＞0.05)2.2.2There were no correlations among FPG, GSP, HbA1c or CD106innormal pregnancy group(P＞0.05).Conclusions:1Since there were disorder of blood glucose metabolism and disfunctionof vascular endothelial cell with the rising of FPG,GSP,HbA1c,CD106inGDM patients, with the aggravating of the disorder of blood glucosemetabolic and the damage of vascular endothelial cell in a certain range,neonatal weight increased. 2. FPG,GSP,HbA1c and CD106could be predictors in late pregnancy ofGDM,if the expressiones of all were high indicated that the probability ofdiabetic macrosomia was higher.And in order to avoid the occurrence of birthtrauma and shoulder dystocia. It was better to terminate pregnancy timely toreduce cesarean rate.