| Objective: This study analyzed the correlation between the blood level changes of GDM patients and the neonatal glucose metabolism disorders by measuring the changes in maternal blood and umbilical cord blood APN,HO-1,serum insulin,glycosylated hemoglobin Alc(HbAlc),fasting plasma glucose(FPG)and other indicators in GDM patients.Moreover,the relationship of the changes of HO-1mRNA level in GDM patients and serum APN as well as other indicators was studied to explore the role of HO-1 adiponection axis in the insulin resistance in GDM patients.Finally,to further understand the pathophysiological mechanism of the occurrence and progress of GDM,the correlation between the changes of the serum and cord blood APN and HO-1 metabolism levels in the GDM patients and the glucose metabolism disorders in neonates was analyzed,so as to provide new ideas for the accurate prediction of the risk of glucose metabolism disorders in neonates and the prevention and treatment strategies for GDM.Methods: According to the diagnostic criteria for GDM and the inclusion and exclusion criteria,60 GDM patients hospitalized in our hospital from January 2019 to July 2019 and 60 neonates were selected as the GDM group.During the same period,60 cases of normal pregnant women with glucose tolerance and 60 cases of newborn babies who delivered in our hospital were selected as the control group.The clinical medical history(age,stature,weight,blood pressure,childbearing history,smoking history,history of alcoholism,etc.)and laboratory clinical data(fasting blood glucose,blood lipid,glycosylated hemoglobin,serum insulin,liver and kidney function,etc.)of the two groups of women were recorded as the baseline indicators.Fasting venous blood of the pregnant woman was collected 1 day before delivery or the same day,and cord blood was collected before delivery of the placenta.Blood glucose of the neonates was measured at the end of the heel at 30 minutes and 2 hours after birth,and 5ml venous blood of the femur was collected 2 hours after birth for examination.The levels of peripheral venous blood,cord blood APN and HO-1 were detected by Elisa.T test was used to compare the differences between the two groups in baseline data,clinical test indicators and the incidence of adverse events.Speraman related analysis method was utilized to analyze the relationship of the peripheral venous blood and cord blood serum APN,HO-1 and clinical data such as fasting blood glucose,glycosylated hemoglobin,serum insulin,and further analyze the association of the peripheral venous blood and cord blood serum APN,HO-1 and the incidence of neonatal sugar metabolism.Results: There were 60 cases in the GDM group and 60 cases in the normal healthy control(NHC)group.There was no difference in general data and baseline clinical test data between the two groups,which was not statistically significant(P > 0.05)and comparable.Compared with the NHC group,the APN levels of the venous blood and umbilical cord blood in the GDM group were significantly reduced,and the difference between the two groups was statistically significant(p < 0.05),the HO-1 levels of the venous blood and umbilical cord blood in the GDM group significantly increased,and the difference between the two groups was statistically significant(p < 0.05).Meanwhile,the APN levels of the venous blood and umbilical cord blood in the GDM group were also significantly different,which was statistically significant(p < 0.05).However,there was no difference in the HO-1 levels of the venous blood and umbilical cord blood in the GDM group,which was not statistically significant(p > 0.05).Compared with the NHC group,the fasting blood glucose level of the GDM group was significantly higher,and the difference was statistically significant(p < 0.05),the glycosylated hemoglobin level in the GDM group was significantly higher,and the difference between the two groups was statistically significant(p < 0.05),the insulin level in the GDM group was significantly higher than that of the NHC group,and the difference between the two groups was statistically significant(p < 0.05).Spearman correlation analysis results showed that the APN level in the peripheral venous blood and umbilical cord blood was negatively correlated with the blood glucose,glycosylated hemoglobin and serum insulin in the GDM group(all P < 0.05).In contrast,the HO-1level in the peripheral venous blood and umbilical cord blood was positively correlated with the blood glucose,glycosylated hemoglobin and serum insulin in the GDM group(all P < 0.05).The risk of macrosomia,hyperbilirubinemia,asphyxia,amniotic fluid aspiration syndrome and full-term low-weight infants in the GDM group was significantly higher than that in the NHC group,with statistically significant differences(all P < 0.05).The number of neonatal glucose metabolism disorders in GDM group was significantly higher than that in NHC group(P < 0.05).The blood glucose level of the newborns 30 minutes and 2 hours after birth in the GDM group was significantly lower than that in the NHC group,with statistically significant differences(P < 0.05).Spearman correlation analysis results showed that there was a significant negative correlation between the peripheral venous blood and umbilical cord blood APN in the GDM group and the occurrence of the neonatal glucose metabolism disorder,while,there was a significant positive correlation between the peripheral venous blood and umbilical cord blood HO-1 in GDM group and the occurrence of the neonatal glucose metabolism disorders.Conclusion:1.The level of venous blood and umbilical cord blood APN in GDM pregnant women significantly decreased with the comparison to normal healthy pregnant women and was negatively correlated with the blood glucose,glycosylated hemoglobin and insulin(FBG,HbAlc,INS),which suggested that the APN plays a important role in the occurrence and progress of the GDM.2.The level of HO-1 in the venous blood and umbilical cord blood in the GDM pregnant women significantly increased with the comparison to normal healthy pregnant women and was positively correlated with the blood glucose,glycosylated hemoglobin and insulin(FBG,HbAlc,INS),which suggested that the HO-1 plays a important role in the occurrence and progress of the GDM.3.Not only the serum APN and HO-1 levels in GDM pregnant women will change,but their umbilical cord blood APN and HO-1 will also change,which will result in the glucose metabolism disorders in neonates. |
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