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| The serum SHBG level and the characteristic of insulin secretion of pregnant women with gestational diabetes mellitus and their relevant with the adverse pregnancy outcomes of the women |
| 1. Zhengzhou Maternal and Child Health Care Hospital, Henan Province, 450000; 2. Zhengzhou Central Hospital Affiliated to Zhengzhou University |
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Abstract To analyze the relationship between the serum sex hormone binding globulin (SHBG) level of pregnant women with abnormal blood glucose levels at different OGTT time points and gestational diabetes mellitus (GDM) and their insulin secretion characteristics and adverse pregnancy outcomes. Methods: The pregnant women with GDM were selected in study group and were divided into group A, group B, group C, and group D according to blood glucose indexes levels at different time points of OGTT from January 2017 to October 2019. These women were also divided in group 1 (women with SHBG≥295) and group 2 (women with SHBG <295) according to their mean serum SHBG level. The pregnant women with normal OGTT results were selected in the control group. The serum SHBG and insulin levels of the women in these groups were detected, and insulin resistance related indexes of these women were calculated. Results: The serum SHBG level and HOMA-β value of the women in the study group were significantly lower than those of the women in the control group, while the serum FINS and HbA1c levels, and HOMA-IR value of the women in the study group were significantly higher (all P<0.05). The serum SHBG level and HOMA-β value of the women in group A, group B, group C, and group D had decreased gradually, while the serum FINS and HbA1c levels, and HOMA-IR value of the women in group A, group B, group C, and group D had increased gradually, which had no significant different between group B and group C (P>0.05), but which had significant different between group A and group D (P<0.05). The serum SHBG level of the women with GDM was negatively correlated with their HOMA-IR value (P<0.05), and was positively correlated with their HOMA-β value (P<0.05). The values of FINS, INS30, INS60, INS120, and INS180, the rate of insulin application, and the incidence premature rupture of membranes of the women in group 2 were significantly higher than those of the women in group 1, but the proportion of satisfied blood glucose control of the women in group 2 was significantly lower (all P<0.05). There were no significant differences in the incidences of premature delivery, polyhydramnios, hypertension during pregnancy of women, fetal distress, and neonatal asphyxia between group 1 and group 2 (P<0.05). The SHBG level <295nmol/L was an independent risk factor of the adverse pregnancy outcomes of the women with GDM (P<0.05). Conclusion: The serum SHBG level of GDM women with abnormal blood glucose at different OGTT time points is slightly different. The low SHBG level of pregnant women may increase the risk of their insulin resistance and adverse pregnancy outcomes.
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