Change And Significance Of Fasting Serum Betatrophin Levels In Patients With Gestational Diabetes Mellitus

ObjectiveTo observe the relationship between fasting betatrophin level in patients with gestational diabetes mellitus,and to analyze the relationship between the fasting betatrophin and the BMI before pregnancy,blood lipid,insulin resistance index and pancreatic beta-cell.Methods(1)120 cases among 24-32 weeks pregnant women were collected from March2016 to August 2016 in the First Affiliated Hospital of Anhui Medical University,According to the standards set by the IADPSG in 2010,pregnant women were divided into GDM group and normal glucose tolerance(NGT)group,The GDM group was divided into normal weight subgroup(BMI<24kg/?,GDM-NW subgroup,n=30)and overweight subgroup(BMI?24kg/?,GDM-OW subgroup,n=30)according to the body mass index(BMI): the NGT group was also divided into two subgroups: the normal weight(BMI<24kg/?,NGT-NW subgroup,n=30)and overweight(BMI?24kg/?,NGT-OW subgroup,n=30).Excluded pregnant women if the fasting blood glucose was higher than 7.0mmol/l.All subjects were excluded from a history of gestational diabetes,acute and chronic infectious diseases,malignancies,severe cardiovascular and cerebrovascular diseases,liver and kidney disease.(2)Age,birth rate,pre-pregnancy weight,history of diabetes mellitus were inquired by questionnaire.Current height and weight were measured(two digits after the decimal point),and gestational weeks was calculated according to the last menstrual,the pre-pregnancy BMI,current BMI and increased BMI during pregnancy were also calculated.(3)All subjects were given no calorie intake for 8 hours,and to collect fasting blood samples next morning,OGTT test was given to all pregnant women,recorded the time when oraled first sugar water,collected venous blood after 1 hour and 2 hour.Determined of blood glucose,insulin,C peptide,calculated(HOMA-IR)and(HOMA-?)based on fasting blood glucose and fasting insulin concentration.The insulin resistance index(HOMA-IR)and islet ?-cell function index(HOMA-?)were measured.Total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were detected using fasting blood samples,1.5ml fasting serum samples were stored at-80?refrigerator,fasting serum betatrophin levels were determinated by enzyme-linked immunosorbent assay(ELISA).Results(1)The general information comparison: age,gestational weeks,increased BMI cholesterol were no difference between GDM group and NGT group,(P>0.05).Fasting blood glucose,P1 hBG,P1hBG,fasting C peptide were higher in GDM group than NGT group(P<0.05);fasting insulin concentration,HOMA-IR were lower however Serum high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)were higher in NGT-NW group than GDM group and NGT-OW group(P<0.05);fasting insulin concentration,HOMA-IR,HDL-C,LDL-C were no significant difference between GDM group and NGT-OW group(P>0.05);HOMA-?ishigher however TG is lower in NGT-OW than GDM-OW group(P<0.05),HOMA-?,TG were no difference between GDM-NW group and NGT-NW group(P>0.05).(2)The serum levels of betatrophin in subgroups: The serum levels of betatrophin were no difference between GDM-NW group and NGT-NW group(P>0.05).The serum levels of betatrophin were higher in GDM-OW group than NGT-OW group and GDM-NW group(P<0.05);The serum levels of betatrophin were no difference between NGT-OW group and NGT-NW group(P>0.05).(3)Correlation between serum betatrophin and other index: Pearson correlation analysis showed that fasting serum betatrophin concentration was positively correlated with pre-pregnancy BMI(r=0.209,P=0.026);Fasting serum insulin(r=0.207,P=0.028);HOMA-IR(r=0.202,P=0.033);TG(r=0.243,P=0.009);fasting serum betatrophin concentration was no correlated with age,Increased BMI,fasting serum glucose,P1 hBG,P2hBG,HOMA-?(P>0.05).(4)Multiple linear regression analysis between serum betatrophin and other indicators: The fasting serum betatrophin as the dependent variable,before pregnancy BMI,fasting insulin,HOMA-IR,TG as the independent variables,multiple linear regression analysis shows that TG is an independent influencing factor of fasting serum betatrophin.Conclusions(1)There are significant hyperinsulinemia and insulin resistance in GDM;(2)The levels of betatrophin is higher in GDM-OW group,betatrophin may be involved in the development of GDM;(3)High levels of serum betatrophin are positively correlated with serum TG andbetatrophin may be involved in the regulation of lipid levels.