Relationship between serum PPARγ,FABP4,CST,and insulin resistance in pregnant women with gestational diabetes mellitus(GDM)and its impact on pregnancy outcomes

Li Hong; Shen Xin; Jian Yingying; Mu Ge; Wang Min; Sun Ganggang; Feng Minjuan

doi:10.11986/j.issn.1673-873X.2024.07.17

Abstract：Objective To investigate the relationship between the expression of peroxisome proliferator-activated receptor gamma(PPARγ),fatty acid-binding protein 4(FABP4),and cortistatin(CST)in pregnant women with gestational diabe-tes mellitus(GDM)and insulin resistance,as well as their impact on pregnancy outcomes,aiming to provide a reference for the clinical intervention of GDM pregnant women.Methods A total of 83 GDM pregnant women treated at Shaanxi Provin-cial People's Hospital from September 2021 to September 2023 were selected as the observation group,and 67 healthy preg-nant women with normal pregnancy check results during the same period were selected as the control group.The pregnancy outcomes of GDM pregnant women were statistically analyzed,and the serum levels of PPARγ,FABP4,CST,and insulin resistance index(HOMA-IR)in the early,middle,and late stages of pregnancy in GDM pregnant women and healthy preg-nant women were compared.Pearson correlation analysis was used to analyze the relationship between PPARγ,FABP4,CST,and HOMA-IR,and to analyze the related factors affecting the pregnancy outcomes of GDM pregnant women.Results The serum levels of FABP4 and HOMA-IR in the observation group were higher than those in the control group during the early,middle,and late stages of pregnancy,while the serum levels of PPARγ and CST were lower than those in the control group,with all differences being statistically significant(P＜0.05).Pearson correlation analysis showed that the serum lev-el of FABP4 in GDM pregnant women was positively correlated with HOMA-IR(r=0.754,P＜0.001),and the serum levels of PPARγ and CST were negatively correlated with HOMA-IR(r=-0.679,-0.836,P＜0.001).A total of 69 normal pregnancies and 14 adverse pregnancies were observed in the observation group;66 normal pregnancies and 1 adverse pregnancy were noted in the control group.The incidence of adverse pregnancy outcomes in the observation group was sig-nificantly higher than that in the control group[16.87％(14/83)vs.1.49％(1/67);x2=9.737,P=0.002].There were no statistically significant differences in age,gestational weeks,and the proportion of hypertension history between GDM pregnant women with different pregnancy outcomes(P＞0.05).The proportion of GDM pregnant women with adverse pregnancies with a body mass index(BMI)＞25 kg/m2,a family history of diabetes,serum FABP4,and HOMA-IR levels were higher than those with normal pregnancies,while the serum levels of PPARγ and CST were lower than those with nor-mal pregnancies,with all differences being statistically significant(P＜0.05).Logistic regression analysis showed that a BMI,a family history of diabetes,and serum levels of PPARγ,CST,FABP4,and HOMA-IR are influencing factors for adverse pregnancy outcomes in GDM pregnant women(P＜0.05).Conclusion The abnormal expression of serum FABP4,PPARγ,and CST in GDM pregnant women is closely related to insulin resistance and pregnancy outcomes.Clinically,effec-tive interventions such as diet and medication should be given to GDM pregnant women to control blood sugar changes,thereby strengthening pregnancy outcomes.