FGF19 and the Expression of IRS-1 and GLUT-1 in Gestational Diabetes Mellitus
Condition: Gestational Diabetes Mellitus
MeSH terms: Diabetes, Gestational; Diabetes Mellitus
Study type: Observational

Summary: 
      Insulin resistance plays a key role in the development of gestational diabetes mellitus(GDM).
      As the largest endocrine organ and the transport intermediary of maternal-fetal nutrient and
      a large of hormone and enzymes, placenta not only plays an important role in insulin
      resistance, but also have a profound effect on fetal growth and development.

      Insulin receptor substrate(IRS)-1, as a key signaling protein, plays vital role in the
      downstream of insulin receptor signaling pathway. Many studies have suggested that the
      central part of insulin resistance may be the insulin receptor substrate defect and the
      abnormal expression of the gene or protein of IRS-1 is one of the molecular mechanisms of the
      dysfunction of the insulin signaling pathway. The expression of IRS-1 and its tyrosine
      phosphorylated protein decreased abnormally in placenta, skeletal muscle and adipose tissue
      of GDM patients, which might be a significant cause to insulin resistance in GDM.

      Besides, glucose transporter-1(GLUT-1), which may play a major role in the glucose
      transporter in the placenta. The increase of blood glucose in patients with GDM has apparent
      up-regulating effect on the expression of GLUT-1 in the placenta, which is associated the
      development of offspring.

      The investigators' previous study showed that FGF19 in serum, placenta and musculus rectus
      abdominis was significantly decreased in patients with GDM, and was related to insulin
      resistance. Thus, the investigators speculate that the abnormal expression of FGF19 may be
      involved in the development of insulin resistance in GDM patients and disorder of
      carbohydrate and lipid metabolism.

      In the present study, the investigators will further investigate the effect of FGF19 on the
      expression of IRS-1/GLUT-1 in cultured trophoblast cells of high glucose, and probe into the
      effect of FGF19 on the insulin resistance and glucose transport.
    

Detailed description: 
      Women who choose to terminate pregnancy because of maternal factors at the first and second
      trimester, or delivered at term in the First Affiliated Hospital of Sun Yat-sen University
      were enrolled in the study.

      Samples for measurement were obtained from women undergoing induced abortion or caesarean
      section. The villous trophoblast extracted from the placental villus were treated with
      recombinant FGF19, high glucose medium or both recombinant FGF19 and high glucose medium or
      neither. By the end of culture, mRNA and protein expression levels of IRS-1/GLUT-1 were
      investigated with real-time quantitative polymerase chain reaction (qRT-PCR) and
      western-blot, respectively. Clinical data were collected and analyzed.

      Data were analyzed by SPSS20.0 database. The results were expressed as mean ± standard
      deviations, median or rate. Differences between groups were assessed by Student's unpaired t
      test, Mann-Whitney U test, or Chi-square test as appropriate. P values of <0.05 were
      considered significant.
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        University hospital
      
Keywords: GDM; IRS-1; GLUT-1