Study of the Relationship Between Vascular Endothelial Growth Factor and Perinatal Outcome of Gestational Diabetes Mellitus

Abstract

Objective To explore the relationship between serum vascular endothelial growth factor (VEGF) and its receptors for VEGF(VEGFR) levels in gestational diabetes mellitus (GDM) women and their perinatal outcomes, and biological effects of serum soluble receptors-1 for VEGF (sVEGFR-1) levels of VEGF-VEGFR axis played. Methods From January to December 2011, a total of 100 cases pregnant women diagnosed with GDM between 24-28 weeks gestational age were recruitment in this study as GDM group. Meanwhile recruitment of another 50 cases of normal pregnant women of corresponding gestational age as control group. Extracted blood samples of pregnant women in two groups, measure glycated index: Fasting plasma glucose(FPG), HbA1c, VEGF. After intervention treatment to GDM group, measured FPG, HbA1c, VEGF again and comparison to control group. Collected after delivery of placenta cryopreservation for analysis of tissue expression of VEGFR protein. And collection of maternals and infants clinical information.According perinatals outcome of GDM group, pregnant women were divided into perinatal outcome normal group(n=66) and perinatal outcome abnormal group(n=34). Informed consent was obtained from all participants. Results ① GDM groups had higher serum VEGF levels, HbA1c and FPG compared with those of control group were much higher, too (P 0.05). Level of serum VEGF remained high.③In GDM group, maternal serum VEGF and sVEGFR-1 levels were negatively correlated(r=-0.497, P<0.01). ④Serum VEGF level in perinatal outcome abnormal group had significantly higher than that in perinatal outcome normal group (P<0.05). ⑤ Multivariate unconditional logistic regression analysis showed that VEGF was a predictor of adverse perinatal outcome in GDM(OR=5.196, 95% CI: 1.845-14.610, P<0.001). ⑥Determined by Western blotting of VEGFR protein expression in the placenta was also much higher of pregnant women in perinatal outcome abnormal group than that in perinatal outcome normal group (P<0.05). Conclusions ①High serum VEGF is negative factor for the GDM perinatal outcome. High levels of VEGF can be used as a GDM abnormal perinatal outcome predictor. ②sVEGFR-1 may be in the blood circulation by competitive binding VEGF. Inhibition of downstream signal transduction. Lower serum sVEGFR-1 levels could be as the GDM lesions of VEGF-VEGFR axis overactive biomarkers. Key words: vascular endothelial growth factor; soluble receptors-1 for VEGF; gestation diabetes mellitus; placenta; perinatal; predictor