Objective To study the relationship of Nesfatin -1,RBP4 with gestational diabetes mellitus (GDM)and macrosomia,and its clinical significance.Methods 40 patients with GDM were selected as the study subjects,15 cases of newborn children were huge (huge child group),25 cases of neonatal were normal children (normal weight children group).40 cases of normal glucose metabolism (NGT)patients at the same period were selected as the control group.Nesfatin -1,RBP4 levels in maternal blood and umbilical blood were detected by ELISA.Results In the huge child group,the Nesfatin -1 levels in maternal blood and umbilical cord blood were positively correlated (r =0.389,P =0.042),the RBP4 levels in maternal blood and umbilical cord blood were positively correlated(r =0.402,P =0.037).In the huge child group,the Nesfatin -1 levels in maternal blood and blood glucose levels were negatively correlated (r =-0.416,P =0.012),the RBP4 levels in maternal blood and blood glucose levels were positively correlated(r =-0.391,P =0.022).Conclusion Nesfatin -1,RBP4 in GDM and maternal blood and umbilical cord blood of huge children have abnormal expression,and Nesfatin -1,RBP4 levels are closely related to the incidence of GDMand huge children,and Nesfatin -1,RBP4 are important morbidity factors of GDMand huge children.