Oxidative stress in maternal milk and cord blood in gestational diabetes mellitus: a prospective study

ABSTRACT BACKGROUND: Reduced antioxidant defenses may reflect a poor protective response against oxidative stress and this may be implicated in progression of gestational diabetes mellitus (GDM). Oxidative stress induced by hyperglycemia plays a major role in micro and macrovascular complications, which imply endothelial dysfunction. OBJECTIVE: Our aim in this study was to investigate the association between GDM and oxidative stress markers measured in plasma, with regard to revealing changes to total antioxidant capacity (TAC) and total oxidant status (TOS) among mothers showing impairments in oral glucose tolerance tests (OGTTs). DESIGN AND SETTING: Prospective study at a university hospital in Turkey. METHODS: The study group consisted of 50 mothers with GDM, and 59 healthy mothers served as controls. Umbilical cord blood samples were taken from all mothers during delivery and breast milk samples on the fifth day after delivery. TAC, TOS, thiol and disulfide levels were measured. RESULTS: No statistically significant relationship between the blood and milk samples could be found. An analysis on correlations between TAC, TOS and certain parameters revealed that there were negative correlations between TOS and total thiol (r = -0.386; P < 0.001) and between TOS and disulfide (r = -0.388; P < 0.001) in milk in the control group. However, these findings were not observed in the study group. CONCLUSION: Our findings suggested that a compensatory mechanism of oxidative stress was expected to be present in gestational diabetes mellitus and that this might be ameliorated through good glycemic regulation and antioxidant supplementation.

Comparative analysis between prevention and treatment costs for gestational diabetes mellitus in primary and tertiary health care in a city in Southern Brazil / Análise comparativa entre os custos de prevenção e tratamento do diabetes mellitus gestacional na assistência à saúde primária e terciária em uma cidade do Sul do Brasil

Objective: The present study's purpose is to evaluate the economic context in which the Brazilian public health system, the only universal public health system with more than 200 million users, stands out. This evaluation will be made through the lens of the execution of gestational health care services in a city of approximately 500 thousand inhabitants in southern Brazil. The care costs of patients with gestational diabetes mellitus (GDM) will be compared to those of patients without GDM, analyzing the different economic valuation methods. And lastly, there was an intent to explore the generated costs in the context of economic valuation applied to health to comprehend better the complexity of the union of the financial and health areas to optimize the services offered. Methods: For the economic context in health, an analysis of health investments was performed through the Transparency Portal. The costs involved in preventing GDM were raised by the Sistema Único de Saúde (SUS) table of procedures performed ordinarily in low-risk pregnancies. The expenses involved in DMG patients were increased at the High-Risk Pregnancy and Fetal Medicine Clinic of DMG patients. Results: Preventing GDM is more cost-effective, cost-minimizing, and cost-useful than treating patients diagnosed with GDM. Conclusion: The result is an extremely interesting costopportunity, given the economic context in which it is presented

Objetivo: O presente estudo tem como objetivo avaliar o contexto econômico em que se encontra o sistema público de saúde brasileiro, único sistema público universal de saúde com mais de 200 milhões de usuários. Essa avaliação será feita sob a ótica da execução de serviços de saúde gestacional em um município de aproximadamente 500 mil habitantes no Sul do Brasil. Os custos assistenciais de pacientes com diabetes mellitus gestacional (DMG) serão comparados aos de pacientes sem DMG, analisando os diferentes métodos de valoração econômica. Também serão analisados os custos gerados no contexto da valoração econômica aplicada à saúde para uma melhor com preensão da complexidade da união das áreas econômica e da saúde com o objetivo de otimizar os serviços oferecidos. Métodos: Para a contextualização econômica em saúde, foi feita a análise dos investimentos em saúde pelo Portal da Transparência. Os custos envolvidos na prevenção da DMG foram levantados pela tabela de procedimentos realizados ordinariamente em gestações de baixo risco do Sistema Único de Saúde (SUS). Os custos envolvidos em pacientes com DMG foram levantados no Ambulatório de Gestação de Alto Risco e Medicina Fetal de pacientes com DMG. Resultados: Prevenir o DMG apresenta maiores custo-benefício, custo-efetividade, custo-minimização e custo-utilidade em comparação com o tratamento das pacientes com o diagnóstico de DMG. Conclusão: O resultado é um custo-oportunidade extremamente interessante, dado o contexto econômico em que se apresenta

Risk factors for gestational diabetes mellitus in advanced maternal age at the early stage of pregnancy / 中国糖尿病杂志

Objective To explore the risk factors for gestational diabetes mellitus (GDM ) in advanced maternal age (AMA) at the early stage of pregnancy .Methods A total of 1200 subjects with AMA were enrolled in this study as AMA group from Jun 2016 to Jul 2017 in Beijing Obstetrics and Gynecology Hospital of Capital Medical University .Each group was further divided according to OGTT results :GDM group and NGDM group .The risk factors of GDM were analyzed .Results The prevalence of GDM was 24.17%(290/1200) .The history of type 2 diabetes in first-degree relatives,pre-pregnancy BMI,TG,FPG,FIns,and HOMA-IR were significantly different in the two groups (P＜0.05) .Pearson correlation analysis showed that GDM was positively correlated with the history of type 2 diabetes in first-degree relatives,pre-pregnancy BMI,TG,FPG,FIns and HOMA-IR (r= 0.519,0.413,0.451, 0.625,0.531,0.214,P＜ 0.05) .Multivariate logistic regression analysis showed that history of type 2 diabetes in first-degree relatives,pre-pregnancy BMI,TG,FPG,FIns and HOMA-IR were independent risk factors for GDM (OR=1.635,1.133,2.153,2.418,1.390,1.901,P＜0.05) .Conclusion During early pregnancy in subjects with AMA,TG,FPG,FIns,history of type 2 diabetes in first-degree relatives,pre-pregnancy BMI were independent risk factors for GDM .

Association between fibroblast growth factor 21 and islet β cell function in pregnant women with different glucose tolerance status / 中国糖尿病杂志

Objective To explore the relationship between fibroblast growth factor 21(FGF21) and islet β cell function in pregnant women with different glucose tolerance status.Methods A total of 441 pregnant women were selected in this study from our hospital.Their 50 g GCT at 24~28 gestational weeks were all positive.One week later,all the subjects were treated with 75 g OGTT,and divided into three groups according to their test results:GDM group (n=228),GIGT group (n=112) and GNGT group (n=91).Serum FGF21 level was tested by ELISA.Islet β cell function was evaluated by HOMA-IR,ISI-Matsuda,HOMA-IS,Stumvoll first,second phase secretion and ISSI.The correlation between FGF21 and islet β cell function was evaluated by Pearson correlation analysis.Results (1) BMI,0 h,1 h,2 h,3 hPG and 1 h,2 h,3 hIns were higher in GDM group and GIGT group than in GNGT group,and highest in GDM group (P0.05).(3)Pearson correlation analysis showed that FGF21 was positively correlated with HOMA-IR(r=0.255,P=0.030) and was negatively correlated with ISI-Matsuda,HOMA-β,Stumvoll first,second phase secretion and ISSI(r=-0.289,-0.256,-0.224,-0.230,-0.277,P=0.019,0.037,0.045,0.040,0.023).Conclusion Along with the worsening of glucose metabolic damage,the FGF21 level is increased gradually.FGF21 is related to islet β cell function,and may enroll in the occurrence and development of GDM.

Research progress of the diagnosis and treatment of gestational diabetes mellitus / 中国糖尿病杂志

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy,excluding diagnosed diabetes or prediabetes before pregnancy.It is one of the most common medical complications of pregnancy.There is almost no agreed diagnostic criteria for GDM until the hyperglycemia and adverse pregnancy outcome (HAPO) published in 2008.IADPSG published new diagnostic criteria for GDM,which is gradually acknowledged by the whole world.IADPSG diagnostic criteria has been adopted in China since 2011.Human insulin is the first-line therapy for GDM.Recently,insulin analogues such as insulin aspart and determir have been approved,and the safety and efficacy of oral antidiabetic drug-metformin are getting more and more attention and certification.Here,we reviewed the research progress of the diagnosis and treatment of GDM.

Challenges and strategies in the management of special population with diabetes / 中国糖尿病杂志

Diabetes prevalence increased year by year,among which population of gestational diabetes mellitus,children and adolecnts with diabetes,and older adults with diabetes were also increased.These special population are different in physiological charateriscs and treatment demands.Here we reviewed the management challenges and strategies for these special diabetes populations.

Impact of reducing cut-point for impaired fasting glucose on the evaluation of the risk of gestational diabetes mellitus / 中华内分泌代谢杂志

_ Objective_ To analyze the relationship between the fasting plasma glucose ( FPG ) of pre-pregnancy women and occurrence of gestational diabetes mellitus( GDM) , and to explore the value of risk evaluation of GDM by lowerling cut-point for impaired fasting glucose ( IFG ) . Methods The general clinic check information before pregnancy, the plasma glucose levels during 24-28 weeks of pregnancy and pregnancy outcomes were collected prospectively in Weifang and Zhucheng Maternal and Child Health Hospital between February 2014 and November 2014. The FPG levels of the recruited women were lower than 6. 1 mmol/L. According to the criteria for GDM of Ministry of Health (MOH)of China in 2011, and based on the results of 75 g oral glucose tolerance test, pregnant women who underwent screening for GDM were recruited and separated into normal group and GDM group. Based on the FPG levels before pregnancy and according to the recommendation as American Diabetes Association ( ADA ) suggested in 2003, recruited women with normal FPG level according to World Health Organization ( WHO) criteria (1999)were divided into 5. 6-6. 1 mmol/L and<5. 6 mmol/L groups. Results Among the child-bearing age women with FPG<6. 1 mmol/L, the incidences of GDM and macrosomia were 19. 2% and 8. 2% respectively. In the group with FPG between 5. 6 and 6. 1 mmol/L, incidences of GDM and macrosomia were 34. 2% and 4. 7%respectively. While in the group with FPG<5. 6 mmol/L, incidences of GDM and macrosomia were 13. 2% and 15. 3% respectively. The risks of GDM and macrosomia were increased by 2. 6 times and 3. 3 times respectively in group with FPG between 5. 6 and 6. 1 mmol/L (34. 5%), compared with that in group with FPG<5. 6 mmol/L(P<0. 01). Age, FPG, and body mass index before pregnancy in GDM group were significantly higher than those in normal group. The receiver operating characteristic curves in predicting GDM showed that the optimum cut-points for age, FPG, and body mass index were 30 years old, 5. 55 mmol/L, and 23. 7 kg/m2 respectively. Conclusions The risk of GDM in childbearing aged women with FPG from 5. 55 to 6. 10 mmol/L was markedly increased. The optimum cut-point for FPG (5. 55 mmol/L) in predicting GDM was close to the low limit for IFG (5. 6 mmol/L) suggested by ADA in 2003. Decreasing the lower limit of IFG to 5. 6 mmol/L among women who checked before pregnancy and paying attention to those women with FPG from 5. 6 to 6. 1 mmol/L would have advantage to the evaluation and prevention of GDM.

A prospective study on outcomes of glucose and lipid metabolism 1 year postpartum in patients with prior gestational abnormal glucose metabolism / 中华内分泌代谢杂志

Objective To elaborate the glucose and lipid metabolism 1 year postpartum on the foundation of postpartum 6-12 weeks in patients with prior gestational abnormal glucose metabolism in Beijing area.Methods Seventy-three patients who delivered during February to December,2007,aged (32.0 ± 3.6) years,were enrolled.46 cases (63％) were diagnosed as cases of gestational diabetes mellitus (GDM) while 27 (37％) as gestational impaired glucose tolerance (GIGT).All of the patients were revisited twice by 6-12 weeks and 1 year postparaum.Body weight,waist andhip circumferences,oral glucose tolerance test(OGTT),and lipids profile were determined.Results Compared with 6-12 weeks postpartum,the body weight,waist and hip circumferences,and waist-to-hip ratio were decreased by 1 year postpartum,fasting plasma glucose was increased [(5.19 ± 0.06) vs (4.84 ± 0.57) mmol/L,P＜0.01],and 4 cases were diagnosed as cases with impaired fasting glucose (IFG; 4 vs 0).By 6-12 weeks and 1 year postpartum,postprandial plasma glucose levels were (6.84± 1.93) and (7.33 ± 1.50) mmol/L(P=0.017),and the incidences of impaired glucose tolerance(IGT) were 28.8％ and 38.4％ (P=0.167),respectively,with 6 cases of newly diagnosed IGT by 1 year postpartum.There were more cases of hypertriglyceridenia (19.2％ vs 13.7％),less cases of hypercholesterolemia(19.7％ vs 30.0％,P＜0.01),more cases with improved high-densit.y lipoprotein-cholesterol (21.9％ vs 4.1％,P＜0.01),and less cases with raised low-density lipoproteincholesterol(21.9％ vs 49.3％,P＜0.01).No difference was found in body weight,body mass index,waist circumference,hip circumference,and waist-to-hip ratio between GIGT and GDM groups.Conclusion GDM is an important cause of the increasing prevalence of diabetes in women of reproductive age.Although body weight and waist-to-hip ratio have been improved,they would still develop glucose intolerance and dyslipidemia 1 year postpartum.

Uso de hipoglicemiantes orales durante la lactancia / Use of oral hypoglycemic agents during breastfeeding

Antecedentes: Los hipoglicemiantes orales son una alternativa emergente en el tratamiento de la diabetes mellitus gestacional (DMG), pero existe poca información acerca de su uso durante la lactancia. Objetivo: Revisar la evidencia respecto a la seguridad del uso de los hipoglicemiantes orales durante la lactancia. Resultados: Encontramos 3 trabajos que evaluaron el paso de metformina a la leche materna: hubo traspaso de metformina a leche materna en todos los casos. La concentración de metformina excretada a la leche fue en promedio 48 por ciento de la concentración plasmática materna. Las dosis calculadas que recibieron los lactantes en promedio fue 0,38 por ciento de la dosis materna, ajustada por peso. La concentración promedio de metformina en los lactantes fue de 0,025 mg/L. No se reportaron efectos adversos en los lactantes, incluso en el seguimiento a 6 meses de vida. Se encontró sólo un trabajo en relación a glibenclamida y lactancia materna, en el que no se detectó excreción del fármaco a la leche materna. Conclusiones: Los hipoglicemiantes orales parecen ser medicamentos seguros durante la lactancia, sin embargo, la evidencia es escasa. Sugerimos el uso de la glibenclamida por sobre metformina, por su nulo paso a la leche materna.

Background: Oral hypoglycemic agents are an emergent therapy for the treatment of gestational diabetes mellitus (GDM), but there is little information about its use during breastfeeding. Objectives: To review the available evidence regarding the use and safety of oral hypoglycemic agents during breastfeeding. Results: We found 3 studies that described the transfer of metformin to breast milk; there was transfer of metformin to breast milk in all cases. The concentration of metformin in breast milk was 48 percent of the maternal plasma concentration. The calculated dose for the infants was 0.38 percent of the maternal weight adjusted dose. The mean concentration of metformin in the infant's plasma was 0.025 mg/L. No adverse effects were reported in the infants, including 6 months of follow-up. Only one study investigated glyburide and breastfeeding, showing no excretion to breast milk. Conclusion: Oral hypoglycemic agents seem to be safe during breastfeeding; however, the available data is scarce. We suggest the use of glyburide over metformin because of its null excretion to breast milk.

Correlation of insulin levels in diabetic mothers and fetal insulin resistance / 中华全科医师杂志

To explore the relationship between maternal insulin levels and fetal insulin resistance.Maternal blood and venous cord blood samples were collected in gestational diabetes mellitus (GDM) mothers and control subjects.The glucose and insulin levels were measured and insulin resistance levels estimated.Maternal levels of insulin and homeostasis model of assessment for insulin resistance index (HOMAIR) were significantly higher in the GDM group than those in the control group (P ＜ 0.05) ; fetal levels of insulin and HOMA-IR were significantly higher in the GDM group than in the control group (P ＜ 0.05).Maternal insulin level positively correlated with fetal insulin (r =0.326,P ＜ 0.05) and HOMA-IR levels (r =0.378,P ＜0.05).In this study,a higher level of fetal insulin resistance was reported in the GDM group.And maternal hyperinsulinemia might affect fetal insulin resistance in pregnant women with GDM.

Functional assessment of islet α-cell and β-cell in patients with gestational diabetes mellitus / 中华内分泌代谢杂志

Based on the result of oral 75 g glucose tolerance test (OGTT),55 pregnant women during the second trimester (gestational age 24-28 weeks) were selected and divided into gestational diabetes mellitus (GDM)group (n =25) and normal glucose tolerance (NGT) group (n =30).Women with GDM were older than those in NGT group.Blood glucose and insulin levels during the OGTT,incremental area under the glucose curve (AUCGLU) and insulin curve (AUCINs) during the OGTT,and basic insulin secretion index (HOMA-β) in the GDM group were higher compared with those in NGT group (P＜0.05).However,in GDM group,insulin sensitivity index (ISI-Matsuda),dynamic insulin secretion index(Stumvoll 1-and 2-phase insulin secretion indices),and insulin secretion-sensitivity index (ISSI)were lowered (all P＜ 0.05),so was AUCINS/AUCGLU (P ＜ 0.01),as compared with those in NGT group.Blood glucagon levels during OGTF and incremental area under the glucagon curve (AUCGL) showed no significant differences between 2 groups (P ＞ 0.05).Multiple linear regression analysis showed that ISI-Matsuda,ISSI,HOMA-β,Stumvoll 1-and 2-phase insulin secretion indices accounted partially for the change of plasma glucose and ISI-Matsuda was the most important one among them.The function of islet α-cell seems to be normal while the function of β-cell is impaired in the patients with GDM,and failure of insulin secretion to overcome insulin resistance is the main reason for GDM.

Investigation on correlation between serum hypersensitivity-CRP and β-cell function in patients with gestational diabetes mellitus / 中国基层医药

Objective To explore the correlation between serum hs-CRP and β-cell finction in patients with gestational diabetes mellitus(GDM).Methods The levels of hs-CRP in 60 patients with GDM(GDM group)and 30pregnant women with normal glucose tolerance(NGT group)were detected.Insulin resistance was assessed by the homeostasismodel insulin resistance index(HOMA-IR),Insulin secretion by the homeostasis β-cell funetiOn index(HOMA-β).Results The levels of hs-CRP and HOMA-IR were higher in GDM group than in NGT group.There was significant difference between two groups(P＜0.01);HOMA-β was lower in GDM group than in NGT group,there was significant difference between two groups(P＜0.05).The level of hs-CRP was correlated with age,pre-pregnant bodymass-index(BMI),screening BMI,fasting blood glucose(FBG),fasting insulin(Fins),and HOMA-IR(r=0.222,0.649、0.862、0.923、0.935、0.941,P＜0.05 or P＜0.01),but was inversely related with HOMA-β(r=-0.872,P＜0.01).Multiple stepwise regression analysis indicated that HOMA-IR and HOMA-β was the most important effect factors of hs-CRP.Conclusion The level of hs-CRP increased in women with GDM.which was related to insulin resistance(IR)and insulin secretion,and it maybe participate in the pathogenesis of GDM.

Morbilidad neonatal y peso al nacimiento en diabéticas gestacionales con tratamiento insulínico preventivo / Neonatal morbidity and birth weight in gestational diabetes patients under preventive insulin-treatment

OBJETIVO: reportar la morbilidad neonatal y el peso de los recién nacidos en diabéticas mellitus gestacionales (DMG), con tratamiento insulínico preventivo o no, portadoras de factores de riesgo para hiperglucemias tardías.MÉTODOS: estudiamos 230 embarazadas DMG en el período 2004-08, las cuales se dividieron en dos grupos, en uno se administró insulina regular humana Novo Nordisk a dosis de 0,3 Ud/kg de peso ideal, dividida en 3 dosis preprandiales según método de Valdés y Márquez más dieta calculada (grupo de intervención), y al otro (grupo control), solo se le administró dieta calculada, en ninguno de los dos grupos menos de 1 800 kcal/día. Utilizamos el test chi-cuadrado y la t de Student para el análisis de los resultados con valor de p<0,05. RESULTADOS: la morbilidad neonatal en lo referente a hiperbilirrubinemia e hipoglucemia neonatal se comportó con una frecuencia de 5,2 y 2,6 por ciento para el grupo de intervención y ello se elevó a 10,4 y 6,1 respectivamente en el grupo control. La frecuencia de exceso de peso corporal neonatal fue de 6,1 por ciento para el grupo de intervención y 25,2 por ciento para el de tratamiento solo con la dieta calculada, la frecuencia de recién nacidos con más de 4 200g fue del 3,5 por ciento en el grupo de insulina preventiva y ello se elevó significativamente a 11,3 por ciento en el grupo control con sólo la dieta calculada. CONCLUSIONES: el tratamiento insulínico preventivo en diabéticas gestacionales con factores de riesgo para hiperglucemia tardía, logró una reducción significativa tanto del exceso de peso corporal como de la macrosomía neonatal según nuestros resultados, muy probablemente por la anticipación lograda a la hiperglucemia tardía

OBJECTIVE: To report the neonatal morbidity and the newborn weight in diabetes mellitus pregnants (DMP) under preventive or not insulin-treatment, carriers of risk factors for late hyperglycemias. METHODS: A total of 230 DMPs were studied during 2004-2008, who were divided into two groups, in one we administered Nordisk Novo human regular insulin at 0.3 Ud/kg dose of ideal weight, divided into 3 preprandial doses according to ValdÚs and Mßrquez method plus a estimated diet (intervention group) and in the other group (control group) only a estimated diet was administered, in no two groups less than 1 800 kcal/day. Chi² test and t Student test were used for results analysis with a value of p < 0.05. RESULTS: The neonatal morbidity concerning the neonatal hyperbilirubinemia and hypoglycemia had a frequency of 5.2 and 2.6 percent for intervention group with a increase of 10,.4 and 6.1, respectively in control group. Frequency of neonatal body weight gain was of 6.1 percent for intervention group and of 25.2 percent for the treatment group only with a estimated diet, newborn frequency above 4.200 g was of 3.5 percent in preventive insulin group increasing significantly to 11.3 percent in control group with only the estimated diet. CONCLUSIONS: Preventive insulin treatment in diabetic pregnants with risk factors for a later hyperglycemia, achieve a significant reduction in body weight excess and in neonatal macrosomia according to our results, very probable by achieved anticipation to late hyperglycemia

Effect of macrophage migration inhibitory factor on insulin resistance and islet β-cell function in gestational diabetes mellitus / 中华内分泌代谢杂志

To study the level of macrophage migration inhibitory factor (MIF) in serum and the expression of MIF mRNA in abdominal subcutaneous adipose tissue,and to investigate its impact on insulin resistance and islet β-cell dysfunction in gestational diabetes mellitus (GDM).120 pregnancy women from the Affiliated Hospital of Qingdao University Medical College and Taian Central Hospital were enrolled,including 60 GDM women and 60 women with normal glucose tolerance (NGT).The serum MIF in GDM group was higher than that of NGT group [(3.58±1.02 vs 1.23±0.62) ng/ml,P<0.01].Multiple stepwise regression analysis showed that body mass index was an independent affective factor of the serum levels of MIF (r2 =0.516).The serum levels of MIF and the expressions of MIF mRNA in abdominal subcutaneous adipose tissue were significantly higher in GDM group than NGT group.MIF may contribute to insulin resistance and β-cell dysfunction in GDM.Body mass index seems to be an independent factor in affecting the serum levels of MIF.

Retinol-binding protein 4 rises significantly in women with gestational diabetes mellitus / 中华内分泌代谢杂志

To investigate the relationship between serum retinol-binding protein 4(RBP4) and gestational diabetes mellitus (GDM) in Chinese Han pregnant women.195 (23-42 years) pregnant women were recruited (July 2005 to December 2007) from the Department of Gynecology and Obstetric in Ruijin Hospital during their visiting for routine prenatal examination.99 subjects belonged to GDM group,and 96 belonged to the group with normal glucose tolerance (NGT).65 non-pregnant healthy women served as control.Serum RBP4 was measured using sandwich enzyme linked immunosorbent assay (ELISA).Pregnant women had higher level of serum RBP4 than that of non-pregnant control.The concentration of serum RBP4 was significantly increased in GDM group as compared with NGT group[(43.04±1.85 vs 33.84±2.17) rag/L,P<0.01].Multiple stepwise regression analysis showed that triglycerides and homeostasis assessment for insulin resistance (HOMA-IR) were independent variables of RBP4 (r2 =0.165) in pregnant women.The results suggest that serum RBP4 level is significantly increased in pregnant women.Women with GDM had even higher RBP4 level than that of normal pregnant women,and RBP4 levele was positively correlated with triglycerides and HOMA-IR.

Expression and tyrosine phosphorylation of insulin receptor substrate-1 in adipose tissue from patients with gestational diabetes mellitns / 中华内分泌代谢杂志

Objective To investigate the expression and tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) and in the adipose tissue of patients with gestational diabetes mellitus (GDM), and to explore molecular mechanisms of insulin resistance in GDM. Methods The serum and adipose tissue were sampled from patients with GDM (GDM group, n = 20) and normal pregnant women (control group, n = 20). Fasting plasma glucose was measured by glucose oxidase assay. The expressions of IRS-1 protein and mRNA were determined by Western blot and semi-quantitative RT-PCR. The tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation. Results Compared with control group, in GDM group, the expression of IRS-1 mRNA was markedly decreased (0.61 ±0.06 vs 1.12 ± 0.17, P < 0.01), the expression of IRS-1 protein was significantly decreased (0.57 ±0.08 vs O. 83 ±0.07, P <0.01) and tyrosine phosphorylation was significantly reduced (0.23 ± O. 06 vs O. 62 ±0.04, P < 0.01) in the adipose tissue. Conclusion The decline of protein expression and tyrosine phosphorylation of IRS-1 in the adipose tissue of gestational diabetes appears to be one of the moleculemechanisms of insulin resistance in patients with GDM.

Study on the changes of the protein conformation of gestational diabetes mellitus (GDM) placenta tissue by using Raman spectroanalysis / 中国糖尿病杂志

Objective To study the protein conformational change of placenta tissue by using Raman spectrum.Methods By using Raman spectroanalysis,we detected the placenta protein conformational change of GDM and control groups.Results(1)In the placenta of GDM,the absorption bands of tryptophan and phenylalanine were increased obviously.(2)In the placenta of GDM,the secondary structure of protein was composed of α-helix,random coil and β-sheet.Conclusions In the placenta of GDM,the orderly conformations of main chains in protein are decreased.Side chains of amino acids,especially tryptophan and phenyl-alanine,are changed greatly.The structure variation of protein may be correlated to the diabetic complications.