| Visfatin, which is secreted mainly by visceral fat, is one of the adipokines.It plays important roles in immune and metabolism. Previous studies hadshown that it played an important role in the pathogenesis of gestationaldiabetes, but the exact mechanism was not clear.PPARγ (peroxisome proliferator activated receptor γ) belongs to theperoxisome proliferator activated receptor family, which is mainly expressedin adipose tissue and plays important roles in the differentiation of adipocyte,metabolism and inflammation. It can be activated by thiazolidinediones(TZDs), and then regulate glucose metabolism.Objective: The aims of the study were to evaluate the levels of visfatin inmaternal and umbilical cord blood, the expressions of visfatin and PPARγ inplacenta of GDM, obese and normal pregnants, and thus to explore the role ofvisfatin and PPARγ in the pathogenesis of GDM. The another aim of the studywas to evaluate the relationship between visfatin and fetal birthweight.Method: A total of sixty cases needed elective cesarean were selectedfrom the Obstetrics and Gynecology, Hebei General Hospital from October2011to April2012，all the candidates were singleton pregnancy.20cases ofGDM pregnants,20cases of obese pregnants and20cases of normalpregnants. Inclusion criteria: complete prenatal examination; excludeddiabetes before pregnancy, gestational hypertension and other pathologicalobstetric diseases; without thyroid diseases, autoimmune diseases, metabolicdiseases, cancer, etc; without medical and surgical diseases; without infection;without premature rupture of membranes. All pregnants were selected withdetailed records of their age, pre-pregnancy weight, height, prenatal weight,gestational age, birthweight, etc, and calculated insulin resistance index(IR-index), the prenatal body mass index(BMI), newborn Ponderal (PI)index. Collected maternal fasting blood in order to test blood glucose, insulin, HbA1c,lipids (cholesterol, triglycerides, high-density lipoprotein, low-densitylipoprotein and very low-density lipoprotein) levels. The levels of visfatin inmaternal and umbilical blood were measured by enzyme-linkedimmunosorbent assay. The expression of visfatin and PPARγ mRNA inplacenta were measured by real-time fluorescence quantitative reversetranscription PCR (FQ RT-PCR), Western blotting was applied to detect theexpression of visfatin and PPARγ protein in placenta.Results:(1) The basic parameters of all pregnants:①T here were significant differencesof BMI in the three groups, thehighest is the obese group(33.20±3.87), followed by gestational diabetesgroup(31.67±3.57), the lowest is the control group(27.32±1.73)(p <0.05);②T he fasting glucose levels of GDM (4.59±0.63mmol/L)weresignificantly higher then control group(4.10±0.40mmol/L)(p<0.05), there wasno significant difference of insulin and insulin resistance index in three groups(p>0.05);③The HbA1clevels in GDM(5.88±0.42) and Obese(5.73±0.53) groupwere significantly higher than that in control group(5.36±0.33)(p<0.05);④There were no significant difference of lipid levels in the three groups(p>0.05);(2) The visfatin levels in maternal and cord blood of GDM group(6.13±3.88;14.00±5.8ng/ml)significantly lower than that in control group(9.20±5.35;25.97±8.10ng/ml)(p<0.05), and the obese group had nosignificantly different compared with that in other two groups (p>0.05);(3) The visfatin levels of cord blood (14.00±5.8;22.34±5.16;25.97±8.10ng/ml)were significantly higher than that in maternal blood (6.13±3.88;7.67±4.35;9.20±5.35ng/ml)in all of the three groups (p <0.05);(4) There were no significant differences of the visfatin expression inplacenta in the three groups,,although the control group was the highestaverage level, and the GDM group was the lowest (p>0.05);(5) There were significant differences about the PPARγ mRNA and protein expression in placenta between GDM(0.60±0.41;0.73±0.13) and thecontrol group(0.26±0.11;0.34±0.09)(p<0.05), but that in obese group had nosignificantly different compared with the other two groups(p>0.05);(6) Correlation analysis showed that: in the GDM group, maternal bloodvisfatin levels were positively correlated with body weight(r:0.54, p:0.01)and body mass index(r:0.56, p:0.01)，the visfatin mRNA in placenta werepositively correlated with PPARγ mRNA expression (r:0.67, p:0.02) andvisfatin in umbilical blood(r:0.58, p:0.048); in control group, maternal bloodvisfatin levels were positively correlated with fasting blood glucose(r:0.57, p:0.01), insulin(r:0.63, p:0.01) and insulin resistance index(r:0.60, p:0.01).Conclusions：1In normal pregnants, maternal blood visfatin levels were positivelycorrelated with fasting blood glucose, insulin and insulin resistance index. Sowe concluded that visfatin was involved in the balance of blood glucose innormal pregnancy, and it was regulated by fasting blood glucose and insulin.2The reduce of visfatin involved in the incidence and development ofGDM, and it was the protecting factor of GDM.3The cord blood had higher visfatin levels which means that visfatinmainly derived from the placenta and fetus. In the GDM group, there waspositively relationship between visfatin mRNA expression and visfatin inumbilical blood, so we speculated that the visfatin of umbilical blood mainlyderived from the placenta but not fetus in GDM4In the GDM group, there was positively relationship between visfatinand PPARγ mRNA expression in placenta，we speculated that the PPARγcould regulate the gene expression of visfatin in the placenta. |
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