Résumé
Objective:To analyze the correlation of glycosylated hemoglobin (HbA 1c) level in the late pregnancy gestational diabetes mellitus (GDM) patients and fetal weights, neonatal Apgar scores, maternal and infant adverse outcomes. Methods:One hundred and eighty-seven pregnant women who were diagnosed with GDM from January 2015 to July 2019 and delivered in Yixing People′s Hospital after standard diagnosis and treatment were divided into four groups (A group: HbA 1c<6.0%, 65 cases; B group: HbA 1c: 6.0% - 6.5%, 49 cases; C group: HbA 1c 6.6%-7.0%, 39 cases; D group: HbA 1c>7.0%, 34 cases) according to the HbA 1c examination results at 28 to 32 weeks of gestation. General data, fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were compared among the four groups. The correlation between GDM HbA 1c and fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were analyzed by unconditional Logistic regression. Results:In general data of GDM pregnant women with different HbA 1c levels, only oral glucose tolerance test (OGTT) fasting blood glucose: (4.68 ± 0.60), (4.89 ± 0.69), (5.23 ± 0.90), (6.48 ± 2.17) mmol/L; postprandial 1 h blood glucose: (9.84 ± 1.56), (10.09 ± 1.84), (10.6 ± 2.01), (12.74 ± 4.12) mmol/L; postprandial 2 h blood glucose: (8.65 ± 1.49), (8.86 ± 1.76), (9.28 ± 2.15), (11.56 ± 4.93) mmol/L, showed statistically significant differences ( P<0.05). Among the newborns of GDM pregnant women with different HbA 1c levels, there were statistically significant differences in the macrosomic infant rates: 1.54%(1/65), 10.20%(5/49), 12.82%(5/39), 17.65%(6/34); rates of neonatal Apgar scores<7 points:13.85%(9/65), 16.33%(8/49), 25.64%(10/39), 44.12%(15/34); the proportion of maternal and infant adverse outcomes: 24.62%(16/65), 24.49%(12/49), 28.21%(11/39), 50.00%(17/34), showed statistically significant differences ( P<0.05). After adjusting OGTT by unconditional Logistic regression analysis, HbA 1c (6.6%-7.0% and>7.0%) was independent risk factor for macrosomic infants: OR = 1.430, 95% CI = 1.035-1.977, P = 0.030; OR = 2.042, 95% CI = 1.311-3.180, P = 0.001; maternal and infant adverse outcomes: OR = 1.774, 95% CI = 1.130-2.874, P = 0.010; OR = 3.387, 95% CI = 1.608-7.133, P = 0.001. HbA 1c>7.0% was independent risk factors for neonatal Apgar scores<7 points: OR = 1.848 95% CI = 1.086-3.143, P = 0.023. Conclusions:There was a significant correlation between HbA 1c in GDM pregnant women in the late pregnancy and macrosomic infants, neonatal Apgar scores, and maternal and infant adverse outcomes. In particular, GDM pregnant women with HbA 1c>7.0% should be alert to the risk of macrosomic infants, neonatal Apgar score<7 points, and maternal and infant adverse outcomes.
Résumé
Objective To investigate the effect of methylation inhibitor decitabine (DAC) alone and combination with As2O3 on apoptosis of NB4 cells. Methods NB4 cells were treated with DAC, As2O3 and the combination of them in different concentrations. The cell proliferation was analyzed by MTT assay and the apoptosis of NB4 cells was detected by flow cytometry. Results Both DAC and As2O3 induced time and concentration-dependent cell death, in which the inhabitation rate were 12.18 %, 22.72 %, 35.54 %, respectively, after 24 h, 48 h, 72 h on treatment by DAC at 1 μmol/L and the inhibition rates were increased to 22.14 %, 31.18 %, 45.21 % by DAC at 1 μmol/L. The inhibition rates were 21.09 %, 32.43 %, 44.93 %, respectively, by treating with As2O3 0.5 μmol/L after 24 h, 48 h, 72 h, which were increased to 31.69 %, 41.12 % and 54.27 %, respectively after 24 h, 48 h, 72 h. The inhibition rates were significantly increased by using both DAC and As2O3 with significant differences (P <0.05). DAC and As2O3 in combination produced a greater inhibition of growth against NB4 cells (by treating with DAC 1 μmol/L + As2O3 0.5 μmol/L after 24 h, 48 h, 72 h, the inhibition rates were 42.10 %, 48.75 %, 60.78 %) (P <0.05). In each concentration group and control group the differences were statistically significant (P <0.05). The incubation for 48 h with As2O3 1 μmol/L alone or combined with DAC 2 μmol/L showed apoptosis cells by 5.8 % and 17.3 %. Conclusion Decitabine can significantly inhibit the proliferation of NB4 cells and the apoptosis with synergistic effectiveness can be found when Decitabine combination with As2O3.