The Correlation Between Insulin Resistance,lipid Metabolism Disorder,Visfatin,RBP4 Levels In Serum And Hypertensive Disorder Complicating Pregnancy

Objectives:①To observe the changes of insulin resistance and lipid metabolism in maternal blood and cord blood of patients with hypertensive disorders of pregnancy(HDP);②To analyze the correlation between Visfatin,retinol-binding protein 4(RBP4)in maternal blood and cord blood,insulin resistance and lipid metabolism,and to identify the role of these factors in the pathogenesis mechanism of HDP.Methods:78 cases of HDP patients were diagnosed at the First Affiliated Hospital of Kunming Medical University,including 29 patients with gestational hypertension(GH),29 patients with early-onset preeclampsia(E-PE)patients and 25 patients with late-onset preeclampsia(L-PE).And 60 cases of normal full-term pregnant women as the control group.All pregnant women were collected 3 ml of the fasting elbow vein blood before delivery,and 3 ml of umbilical artery and umbilical vein blood were collected during childbirth.The serum was collected after centrifugation.The fasting blood glucose was determined by glucose oxidase method,and the five items of blood lipids were determined by mass spectrometry.Serum Visfatin,RBP4,insulin and C peptide were determined by ELISA.The experimental data were statistically processed using SPSS 23.0 software.Results:Part 1 Changes in serum insulin resistance and lipid metabolism in patients with HDP①The content of FINS,C-peptide and HOMA-IR in the maternal blood,umbilical artery and umbilical vein of the HDP group were significantly higher than those of the control group(P<0.05),while the ISI was significantly lower than the control group(P<0.05).The HOMA-IR in maternal blood of E-PE group was significantly higher than that of GH group,L-PE group and control group(P<0.05).The HOMA-IR of maternal blood in GH group and L-PE group was significantly higher than that of control group(P<0.05).<0.05).The HOMA-IR in umbilical artery and umbilical vein of E-PE group was significantly higher than that of GH group,L-PE group and control group(P<0.05).②The content of TC in the maternal blood of the HDP group was significantly higher than that of the control group(P<0.05).The content of HDL-C in maternal blood and umbilical vein of HDP group was significantly lower than that of the control group(P<0.05).The content of TC,FC and LDL-C in maternal blood of E-PE group were significantly higher than those of GH group and control group(P<0.05).The content of HDL-C in maternal blood of E-PE group was significantly lower than that of GH group,L-PE group and control group(P<0.05);The content of HDL-C content in the umbilical vein of E-PE group was significantly lower than that of the control group(P<0.05).The content of TG in the umbilical vein of the E-PE group was significantly higher than that of the GH group and the control group(P<0.05).Part 2 Correlation and mechanism of Visfatin,RBP4,insulin resistance and lipid metabolism in serum of patients with HDP①The content of Visfatin in maternal blood,umbilical artery and umbilical vein was significantly higher in HDP group than in control group(P<0.05).The content of Visfatin in maternal blood and umbilical arteries of E-PE group and L-PE group was significantly higher than that of GH group and control group(P<0.05).The content of Visfatin in maternal blood and umbilical arteries of GH group was significantly higher than that of control group(P<0.05).The content of Visfatin in umbilical vein:E-PE group>L-PE group>GH group>control group(P<0.05).②The content of RBP4 in the maternal blood of the HDP group was significantly higher than that of the control group(P<0.05).The content of RBP4 in maternal blood of E-PE group was significantly higher than that of GH group and control group(P<0.05).The content of RBP4 in maternal blood of GH group and L-PE group was significantly higher than that of control group(P<0.05).There was no significant difference in RBP4 content between umbilical cord and vein.③The content of Visfatin was positively correlated with FINS,C peptide and HOMA-IR in maternal blood and cord blood of HDP group,and negatively correlated with ISI.There was a positive correlation between Visfatin and TC in maternal blood of HDP group and control group,and correlation:HDP group>control group.There was a positive correlation between Visfatin and TG and LDL-C in umbilical cord blood of control group and HDP group,and negative correlation with HDL-C.①The content of RBP4 was positively correlated with FPG and HOMA-IR in maternal maternal blood of control group and HDP group,and negatively correlated with ISI.The content of RBP4 in the HDP group was positively correlated with TC,FC and LDL-C.The content of RBP4 in the HDP group was positively correlated with TG.Conclusions:①In the serum of HDP patients,there are excessive insulin secretion,decreased insulin sensitivity,insulin resistance and lipid metabolism disorder,among which E-PE patients are the most significant.②The expression of Visfatin in maternal,umbilical and umbilical veins of HDP patients was positively correlated with disease severity.③The RBP4 content in maternal blood of HDP patients was positively correlated with the severity of the disease.④Visfatin and RBP4 may cause HDP infection by mediating insulin resistance and lipid metabolism disorder.⑤Placenta may have a significant barrier effect on Visfatin,RBP4 and blood lipids,or there may be differential transport between fetal and maternal.