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| Expression and correlation of 25(OH)D level and Lp-PLA2 level in peripheral blood of pregnant women with gestational diabetes mellitus |
| Xinhua Hospital, Huainan Xinhua Medical Group, Huainan, Anhui Province, 232052 |
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Abstract To investigate the expression and correlation of 25-hydroxyvitamin D［25(OH)D］and lipoprotein-associated phospholipase A2 (Lp-PLA2) in peripheral blood of the pregnant women with gestational diabetes mellitus (GDM). Methods: From January 2017 to January 2019, 63 women with GDM were selected in study group, and 30 normal pregnant women were selected in control group during the same period. The clinical features, the glucolipid metabolic indexes, the rate of maternal and perinatal infant complications of the women were compared between the two groups. The 25 (OH) D level and Lp-PLA2 activity in peripheral blood of the women in two groups were detected, and the relationship between the 25 (OH) D level and Lp-PLA2 activity was analyzed. The correlation of the level of 25 (OH) D and Lp-PLA2 activity of GDM women with their clinical characteristics and blood lipid metabolism was also analyzed. The occurrence of abnormal postpartum glucose metabolism of the women with GDM was statistically analyzed, and the influencing factors were analyzed by Logistic regression. Results: The body mass index (BMI) value, the levels of pre-pregnancy triglyceride (TG), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), fasting blood glucose (FPG), glycated hemoglobin (HbA1c), and fasting blood glucose, and the values of insulin resistance index (HOMA-IR) and insulin secretion index (HMOA-β) of the women had significant different between the two groups (P＜0.05), but age, gestational weeks, and total cholesterol (TC) level had no significant different between the two groups. The 25(OH) D level (10.17±2.02 ng/ml) in peripheral blood of the women in the study group was significant lower than that (22.16±3.15 ng/ml) of the women in the control group, and the Lp-PLA2 activity (33.49±6.32 nmol/min/ml) of the women in the study group was significant higher than that (23.15±4.16 nmol/min/ml) of the women in the control group (P＜0.05). The incidences of premature rupture of membranes (23.8%), gestational hypertension (31.8%), and premature delivery (19.1%) of the women in the study group were significant higher than those of the women in the control group (P＜0.05). Pearson correlation analysis showed that the level of 25(OH) D in peripheral blood was negative correlated with their FPG level and HMOA-IR value. The Lp-PLA2 activity of the women in the study group was positive correlated with their BMI and HMOA-IR values, and was positive correlated with the levels of TG, LDL, and FPG before pregnancy, but was negative correlated with their HMOA-β value. The level of 25(OH) D of the women in the study group was negative correlated with their Lp-PLA2 activity (all P＜0.05). Lp-PLA2 activity was an independent risk factor of abnormal postpartum glucose metabolism of the women with GDM, but the level of 25 (OH) D was a protective factor of abnormal postpartum glucose metabolism of the women with GDM. Conclusion: The pregnant women with GDM have severe glucose and lipid metabolism disorders with higher adverse events. The 25 (OH) D level and Lp-PLA2 activity in peripheral blood of these women are abnormal, which both are correlations with their clinical characteristics and glucose and lipid metabolism, and may promote development of GDM by interaction.
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