Study on the correlation between the changes of TNFR1, TNF-α, and adiponectin in patients with gestational diabetes mellitus and insulin resistance

Abstract

Gestational diabetes mellitus (GDM) refers to pregnant women with impaired glucose tolerance, which could bring high risk to the mother and fetus. However, the early diagnosis and treatment of GDM remained unclear. In this study, 60 patients with GDM were selected as the research group and 50 healthy pregnant women as the control group. Tumor necrosis factor receptor 1 (TNFR1), tumor necrosis factor-α (TNF-α), and adiponectin (ADP) in the serum were measured by enzyme-linked immunosorbent assays (ELISAs). The levels of fasting blood glucose (FBG), fasting insulin (FINS), and glycosylated hemoglobin (HbA1c) were also detected to calculate homeostasis model assessment insulin resistance index (HOMA-IR) and pancreatic β-cell function index (HOMA-HBCl). Compared with the control group, the serum levels of TNFR1, TNF-α, and HbA1c in research group were significantly increased ( P < 0.05), while ADP showed lower levels ( P < 0.01). Furthermore, FBG, FINS, and HOMA-IR were evidently increased ( P < 0.05), while homeostasis model assessment insulin secretion index (HOMA-β) and insulin sensitivity index (ISI) were decreased ( P < 0.05) in research group. TNFR and TNF-α were positively correlated with FBG, FINS, and HOMA-IR ( P < 0.05). In addition, there was a significant negative correlation between ADP and FINS and HOMA-IR ( P < 0.01). From logistic regression analysis, age, gestational age, FBG, FINS, TNFR1, TNF-α, and ADP ( P < 0.05) were shown to be risk factors to affect the function of islet β-cells. In conclusion, the high levels of TNFR1 and TNF-α and the low levels of ADP in the second trimester of pregnancy are the risk factors of GDM, which are related to the insulin resistance and impaired pancreatic β-cell function.