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| Expression of the levels of serum visfatin and sex hormone-binding globulin of pregnant women with gestational diabetes mellitus and their correction with the condition of gestational diabetes mellitus and the pregnancy outcomes |
| Rugao People's Hospital，Jiangsu Province, 226500 |
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Abstract To explore the changes of the levels of serum visfatin and sex hormone-binding globulin (SHBG) of pregnant women with gestational diabetes mellitus (GDM), and to study the correlation between the levels of serum visfatin and SHBG of the women and their condition of GDM and their pregnancy outcomes. Methods：The clinical data of 102 pregnant women with GDM (in observation group) who had received regular prenatal examination and delivery from November 2017 to December 2019 were selected. Another 98 healthy pregnant women were selected in control group during the same period. The expression levels of visfatin and SHBG，the value of homeostasis model assessment of insulin resistance (HOMA-IR), and the pregnancy outcomes of the women were compared between the two groups. Pearson method was used to analyze the correlation between the expression levels of visfatin and SHBG of the women and their HOMA-IR value. According to the occurrence of adverse pregnancy outcomes，the women with GDM were divided into group A (49 women with adverse pregnancy outcomes) and group B (53 women with normal pregnancy outcomes). The expression levels of visfatin and SHBG of the women were compared between group A and group B. Multivariate Logistic regression model analysis was used to analyze the risk factors of the adverse pregnancy outcomes of the women with GDM. Receiver operating characteristic (ROC) curve was used to analyze the value of serum visfatin and SHBG levels of the women with GDM for evaluating their adverse pregnancy outcomes. Results：The serum visfatin level (64.73±18.26 mmol/L) and the HOMA-IR value (2.79±0.91) of the women in the observation group were significantly higher than those (33.59±10.91 mmol/L and 1.72±0.63) of the women in the control group. The SHBG level (415.05±50.54 mmol/L) of the women in the observation group was significantly lower than that (573.41±59.68 mmol/L) of the women in the control group (all P=0.000). The serum visfatin level was positively correlated with their HOMA-IR value (r=0.469, P=0.000), and the serum SHBG level of the women with GDM was negatively correlated with their HOMA-IR value (r=-0.474, P=0.000). The incidences of hypertension, cesarean section, macrosomia, and neonatal hypoglycemia of the women in the observation group were significantly higher than those of the women in the control group. The serum visfatin level of the women in group A was significantly higher than that of the women in group B, but the SHBG level of the women in group A was significantly lower (all P<0.05). The serum visfatin and SHBG levels of the women with GDM were the independent risk factors of their adverse pregnancy outcomes (P<0.05). The area under the curve (0.871) of the combination the serum visfatin and SHBG levels for evaluating the adverse pregnancy outcomes of the women with GDM was significantly higher than that (0.782) of the serum visfatin level alone and that (0.734) of the serum SHBG level alone (P<0.05). Conclusion：The level of visfatin of the women with GDM significantly increases, and the level of SHBG of the women with GDM significantly decreases，and both of which are related to the HOMA-IR value of the women. The levels of serum visfatin and SHBG of the women with GDM may be used to evaluate their adverse pregnancy outcomes.
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