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Correlation of TNF-a, TNFR1 and adiponectin levels with HOMA-IR in patients with gestational diabetes mellitus

Xiaoxia Zhou, Jiachen Liao, Huan Pan, Shu Zhou

Objective: To investigate the correlation of serum Tumor Necrosis Factor α (TNF-α), Tumor Necrosis Factor Receptor 1 (TNFR1) and Adiponectin (ADP) with insulin resistance index (HOMA-IR) in patients with Gestational Diabetes Mellitus (GDM) and to analyze the relationship between the levels of TNF-a, TNFR1 as well as ADP during pregnancy period and adverse pregnancy outcomes as well as postpartum progression to type 2 diabetes mellitus (T2DM).

Method: A total of 240 pregnant women who received regular prenatal examination in our hospital from January 2017 to September 2017 were selected as the research objects, among whom 180 patients diagnosed with gestational diabetes mellitus were set as patient group with other 60 normal pregnant women as control group. The selected patients were examined on Fasting Plasma Glucose (FPG), Fasting Serum Insulin (FINS), Glycosylated Hemoglobin (HbAlc), Total Cholesterol (TC), Three Glycerol (TG), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), TNF-a, TNFR1 and ADP with HOMA-IR calculated by formula, which was followed by the analysis on the correlations of HOMA-IR with various indexes, of pregnancy outcome with serum index and of postpartum progression to T2DM with serum index.

Results: Compared with the control group, the levels of FPG, FINS, HbAlc, LDL, HOMA-IR, TNF-a and TNFR1 were significantly increased while ADP obviously decreased in patient group. Multivariate Logistic regression analysis showed: in patient group, the levels of FPG, FINS, HbAlc, TG, HDL, LDL, TNF-a and TNFR1 showed a positive correlation with HOMA-IR. ADP showed a significant negative correlation with HOMA-IR. The adverse pregnancy outcome was positively correlated with HOMA-IR, TNF-a and TNFR1 while negatively correlated with ADP. The postpartum progression to T2DM was positively correlated with HOMA-IR, TNF-a and TNFR1 while negatively correlated with ADP.

Conclusion: In patients with gestational diabetes the levels of TNF-a and TNFR1 are relatively high and ADP level moderately low, which is closely related with insulin resistance.