| Objective To study the relationship between blood glucose and lipid metabolism in pregnant women with gestational diabetes mellitus(GDM),the relationship between blood glucose,blood lipid and the weight of the newborn,and to analyze the related risk factors of the macrosomus;and on the basis of the successful establishment of the mouse GDM model,To observe the therapeutic effect of Liuwei Dihuang pill on the pregnant rats and its progeny mice of the GDM model,and to explore the possible mechanism of the treatment of the GDM model pregnant rats and their offspring.Methods In the first part of clinical study,serum total cholesterol(total cholesterol,TC),total glycerol(total glyceride,TG),fasting blood glucose(fasting blood glucose,FPG),postmeal blood glucose(1hour postprandial blood glucose,1h PBG),total cholesterol(total cholesterol,TC),fasting blood glucose(fasting blood glucose,FPG)and postmeal blood glucose(1hour postprandial blood glucose,1h PBG)were studied in GDM group.2 hours postmeal blood glucose(2hour postprandial blood glucose,2h PBG)and glycosylated hemoglobin(glycosylated hemoglobin,Hb Alc)were significantly higher than those in the control group(P < 0.05).The age of pregnant women,body mass index(body mass index,BMI)before pregnancy,weight gain during pregnancy(pregnancy weight gain,GWG)and neonatal weight in GDM group were significantly higher than those in control group(P < 0.05).The(high density lipoprotein-c,HDL-C of high density lipoprotein in GDM group during pregnancy was significantly lower than that in control group(P <0.01).There was no significant difference in low density lipoprotein(Low density lipoprotein-c,LDL-C between GDM group and control group(P > 0.05).The maternal MBI before pregnancy and the weight gain during pregnancy in the macrosomia group were significantly higher than those in the normal weight group(P <0.05).Maternal HDL-C in macrosomia group was significantly lower than that in normal weight group(P < 0.05).2h PBG in macrosomia group was higher than that in normal weight group(P > 0.05).There was a positive correlation between TC,TG,LDL-C,FPG,1h PBG,2h PBG,Hb Alc,GWG and MBI before pregnancy and neonatal weight(P < 0.05)In the second part of the experimental study of pregnant rats,the animal model was established by intraabdominal injection of streptozotocin.On the basis of the success of the model,the pregnant rats in the intervention group were given Liuwei Dihuang pill suspension intragastrically since the 9th day of pregnancy.The pregnant rats in the model group and the control group were given the same amount of saline as the intervention group once a day until the 18 th day of pregnancy.Fasting blood glucose was measured on the 1st,6th and 14 th day of pregnancy,respectively,on the 19 th day of pregnancy.On the 19 th day of pregnancy,6 pregnant rats were randomly selected and killed,and the serum of pregnant rats wascollected.Fasting blood glucose was measured,fasting blood lipid and serum insulin level were measured by enzyme-linked rabbit epidemic adsorption assay(ELISA),and insulin resistance index was calculated.In the third part of the experimental study,4 pregnant mice in each group were left for natural delivery,and 8 offspring mice in each group were randomly selected as the offspring intervention group,the offspring model group and the offspring control group.The mice in each group were weighed by electronic scale every 2 weeks.After feeding the offspring mice for 20 weeks,glucose tolerance test was carried out by intraabdominal injection of glucose,and then the mice in each group were killed.Pancreatic tissue and serum samples were collected.Fasting serum insulin level was measured by Elisa and insulin resistance index was calculated.HE staining was used to observe the morphological changes of pancreatic tissue in each group.Results In the first part of clinical study,serum total cholesterol(total cholesterol,TC),total glycerol(total glyceride,TG),fasting blood glucose(fasting blood glucose,FPG),postmeal blood glucose(1hour postprandial blood glucose,1h PBG),total cholesterol(total cholesterol,TC),fasting blood glucose(fasting blood glucose,FPG)and postmeal blood glucose(1hour postprandial blood glucose,1h PBG)were studied in GDM group.2 hours postmeal blood glucose(2hour postprandial blood glucose,2h PBG)and glycosylated hemoglobin(glycosylated hemoglobin,Hb Alc)were significantly higher than those in the control group(P < 0.05).The age of pregnant women,body mass index(body mass index,BMI)before pregnancy,weight gain during pregnancy(pregnancy weightgain,GWG)and neonatal weight in GDM group were significantly higher than those in control group(P < 0.05).The(high density lipoprotein-c,HDL-C of high density lipoprotein in GDM group during pregnancy was significantly lower than that in control group(P <0.01).There was no significant difference in low density lipoprotein(Low density lipoprotein-c,LDL-C between GDM group and control group(P > 0.05).The maternal MBI before pregnancy and the weight gain during pregnancy in the macrosomia group were significantly higher than those in the normal weight group(P <0.05).Maternal HDL-C in macrosomia group was significantly lower than that in normal weight group(P < 0.05).2h PBG in macrosomia group was higher than that in normal weight group(P > 0.05).There was a positive correlation between TC?TG?LDL-C?FPG?1h PBG? 2h PBG?Hb Alc?GWG and MBI before pregnancy and neonatal weight(P < 0.05).The second part of pregnant rat experimental study,three groups of pregnant rats fasting glucose comparison: pregnant rat 1 d model group,the intervention group and control group there was no statistically significant difference fasting plasma glucose(P >0.05),pregnant rats fasting glucose 6 d model group and intervention group was obviously higher than that of control group,the difference was statistically significant(P < 0.01),while there was no statistically significant difference model group and intervention group(P > 0.05),pregnant rats 14 d,19 d model group and intervention group blood sugar is higher than the control group,the intervention group compared with model group,the difference had statistical significance(P < 0.05);Three groups of pregnant rats fasting insulin level and insulin resistance index comparison:model group and intervention group fasting serum insulin level andinsulin resistance index were higher than control group,the difference was statistically significant(P < 0.05),while the intervention group compared with model group fasting serum insulin level and insulin resistance is reduced,the difference was statistically significant(P < 0.05);TG and TC levels in the model group were significantly higher than those in the control group(P< 0.05),while those in the intervention group were lower than those in the model group(P < 0.05).Hdl-c levels in the three groups were not statistically significant(P > 0.05).Ldl-c of the model group and the intervention group was higher than that of the control group,and the difference was statistically significant,while that of the intervention group was lower than that of the model group,but the difference was not statistically significant(P > 0.05).The third part of the experimental study of offspring mice,compared with the body weight of the three groups,the body weight of the offspring model group was higher than that of the offspring control group,the difference was statistically significant(P <0.05),compared with the offspring model group,the body weight of the offspring model group was significantly higher than that of the offspring control group(P < 0.05).The weight of mice in the offspring intervention group decreased at all stages,but there was no significant difference at 2 weeks(P > 0.05),but there was significant difference in other periods(P < 0.05).Compared with the control group,the body weight of the mice in the offspring intervention group was higher than that in the control group at each stage,but there was no significant difference at 0W,4wand 8w(P >0.05),but there was significant difference in the rest of the period.The glucose tolerance test of the three offspring mice at20 weeks showed that the blood glucose levels of 90 min and 120 min in the model group were significantly higher than those in the control group and the intervention group at 0 min,30 min and 60 min,respectively,the difference was statistically significant.At 0 min,30 min,90 min and 120 min blood glucose in the intervention group were lower than those in the model group.The difference was statistically significant.The blood glucose in the intervention group was higher than that in the control group,but there was no significant difference in 30 min and 120 min,but there was significant difference in the rest of the period.The results of HE staining showed that the pancreatic tissue of the offspring model group was obviously damaged,the pancreatic tissue injury of the offspring intervention group was better than that of the offspring model group,and the morphology of the pancreatic tissue of the offspring control group was normal.Conclusion:(1)the glucose and lipid metabolism of GDM pregnant women is obviously disordered during pregnancy,and the level of TC?TG?LDL-C?FPG?1h PBG?2h PBG?Hb A1 c during pregnancy is positively correlated with neonatal weight.Excessive BMI before pregnancy,excessive weight gain during pregnancy,abnormal blood glucose and blood lipids,GDM are the risk factors of delivery macrosomia.(2)GDM is the occurrence of abnormal glucose tolerance in offspring.One of the risk factors of overweight or obesity and insulin resistance.Liuwei Dihuang pills can not only reduce blood glucose,blood lipid and improve insulin resistance in pregnant mice with GDM model,but also reduce obesity and insulin resistance in GDM model offspring.The mechanism of abnormal glucose tolerance may be to improve insulin resistance in GDM model pregnant mice.Conclusions(1)the glucose and lipid metabolism of GDM pregnant women were obviously disordered during pregnancy,and the level of TC,TG,LDL-C,FPG,1h PBG,2h PBG,Hb A1 c during pregnancy was positively correlated with neonatal weight.Excessive BMI before pregnancy,excessive weight gain during pregnancy,abnormal blood glucose and blood lipids,GDM are the risk factors of delivery macrosomia.(2)GDM is the occurrence of abnormal glucose tolerance in offspring.One of the risk factors of overweight or obesity and insulin resistance.Liuwei Dihuang pills can not only reduce blood glucose,blood lipid and improve insulin resistance in pregnant mice with GDM model,but also reduce obesity and insulin resistance in GDM model offspring.The mechanism of abnormal glucose tolerance may be to improve insulin resistance in GDM model pregnant mice. |
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