Study On The Relationship Between Chemerin And Gestational Diabetes Mellitus And Adverse Pregnancy Outcome

Objective: Gestational diabetes mellitus(GDM)is defined as the first occur or detected diabetes during pregnancy in women of normal reproductive age.Through the analysis of the risk factors of GDM patients and the results of laboratory exmaination,the study explored the correlation bewteen chemerin levels and the occurrence of GDM and adverse outcome of pregnancy to provide a new idea for the prevention and treatment of gestational diabetes.Method:1.In this study,women with gestational weeks ranging from 24 weeks to 28 weeks were divided into GDM group and non-GDM group according to the results of blood glucose screening.Sometric sampling method of systematic sampling was applied to enroll 300 cases of GDM pregnant women as the case group and 300 cases of non-GDM pregnant women as the control group in this 1:1 matched case-control study according to gestational month(observation to delivery end).Comparing the survey indicators to make risk assessment and collecting the experimental detection results of the two groups of subjects were to analyze the risk factors related to the occurrence of GDM.The levels of peripheral blood chemerin,prenatal peripheral blood chemerin and umbilical blood chemerin in the second trimester were respectively detected.The m RNA expression of chemerins in abdominal adipose tissue and placental tissue was detected by real-time quantitative reverse transcription PCR.Western blot was used to detect the expression of chemerin in adipose tissue and placental tissue,and to discuss the relationship between chemerin and GDM.2.The two groups of subjects were observed until the end of delivery,and the pregnancy outcomes were collected and statistically analyzed.The occurrence of adverse pregnancy outcomes with different chemerin levels was observed in all the subjects to explore the relationship between chemerin and adverse pregnancy outcomes with GDM.Result: 1.Age,education level,family income,pre-pregnancy BMI index,prenatal BMI index,weight gain,history of abortion,history of thyroid disease and family history of diabetes were significantly different between GDM group and control group(P<0.05 for each).There were no significant differences in household registration,pregnancy,parity,passive smoking history,and family history of hypertension(P>0.05)between the twogroups.The levels of Hemoglobin Alc,fasting insulin,insulin resistance index,fibrinogen(FIB),DD dimer,triglyceride,and serum chemerin content were higher in the GDM group than in the non-GDM group;whereas the high-density lipoprotein cholesterol ester was lower than was non-GDM.The difference between the two groups was statistically significant(P<0.05).There were no significant differences in total cholesterol and low-density lipoprotein cholesterol ester between the two groups(P>0.05).Logistic regression analysis showed that age difference,annual household income,diabetic family history,pre-pregnancy BMI index and serum chemerins were risk factors for GDM While education level was a protective factor for GDM.Spearman correlation analysis of serum chemerins and various factors,prenatal BMI(rs=0.699,P<0.001),pre pregnancy BMI(rs=0.563,P<0.001),family history of diabetes mellitus(rs=0.388,P<0.001),insulin resistance index(rs=0.251,P<0.001),history of thyroid disease(rs=0.197,P< 0.001),fasting blood glucose(rs=0.124,P=0.003)were related variables.The levels of prenatal serum and umbilical cord blood chemerin in GDM group were higher than those in the control group,and the differences were statistically significant(P<0.05).The results of fluorescence PCR showed that the level of chemerin m RNA in the adipose tissues and placental tissues was different in the two groups(P<0.05).The expressions of chemerins in placenta and adipose tissues detected with the Western blot were higher in the GDM group than in the non-GDM group,and the difference was significant(P<0.05).2.The incidence of polyhydramnios,premature rupture of membranes,premature delivery,macrosomia and group B streptococcal infection,in adverse pregnancy outcomes were significantly higher in the GDM group than in the control group,and the difference was statistically significant(P<0.05).There was no statistical difference in the incidence of pre-eclampsia and neonatal obsessive-compulsive disorder in two groups(P>0.05).The occurrence ratio of adverse pregnancy outcomes with different chemerin levels was different.The higher chemerin level can lead to the higher incidence of adverse pregnancy outcomes,and the difference was statistically significant(P<0.05).Among all the adverse outcomes of pregnancy,the higher the level of peripheral blood chemerins in the fourcategories of hyperamniotic fluid,premature rupture of membranes,premature delivery and macrosomia lead to the higher the incidence of adverse outcomes of pregnancy.Conclusions:1.In patients with gestational diabetes mellitus,chemerin expression in peripheral blood was significantly increased in the second trimester,so chemerin was correlated with GDM and was a risk factor for the occurrence of GDM.The Chemerins of prenatal peripheral blood of GDM,umbilical blood,abdominal adipose tissue and placental tissue were higher than those in the non-GDM group,indicating that the increase of chemerins during pregnancy is a risk factor for the occurrence of adverse pregnancy outcomes of GDM.2.Chemerins may have potential application value in screening and evaluating GDM in early and second trimester and the intervention of GDM in adverse pregnancy outcomes.