Objective:To evaluate the association between weight gain in late gestation and glycated albumin (GA),visfatin level and neonatal body composition in gestational diabetes mellitus (GDM) patients who are non-obese.Methods:200 pregnant women were enrolled.The preconception body mass index(BMI) of all the research object was less than 25 kg/m2.According to the speed of body mass growth from 28th week of gestation to delivery,the subjects were divided into two groups:excessive weight gain group (n =77) and appropriate weight gain group(n=123).Variance of serum GA,visfatin levels and neonatal birth weight(BW),the percent of body fat in newborn(F％) between two groups were compared,and the relationship between weight gain in late pregnant GDM patients and above values was analyzed.Results:①Serum GA,HbA1 c,visfatin and total cholesterol,triglyceride,low density lipoprotein,very low density lipoprotein levels in excessive weight gain group were higher than those in appropriate weight gain group(P ＜ 0.05).②Mean gestational age,newborn Apgar score immediately,the ratio of baby boys and vaginal delivery rate in two group had no significant difference(P＞0.05).Compared with the appropriate weight gain group,the excessive weight gain group had higher average birth weight and lower blood glucose levels.The proportion of large for gestational ages(LGA) was increased in appropriate weight gain group,and the ratio of abdomen circumference (AC) and head circumference (HC) and the percent of body fat in newborn(F％) were significantly increased in this group(P ＜0.01).③The speed of body mass growth in late pregnancy in GDM patients was positively related with serum GA,visfatin,HbA1c levels and newborn birth weight and the percent of body fat in newborn(r=0.524,0.470,0.456,0.329,0.473,P＜0.001).Conclusions:The monitoring of the serum GA and visfatin levels may have certain clinical value to evaluate the weight gain in late pregnancy of GDM patients.The rapid body mass growth in those patients may accelerate the visceral fat accumulation and worsen existing glucolipid metabolic disorders,and is also closely related to the increase of neonatal BW and F％.

Objective To investigate the relationship between the levels of serum glycosylated hemoglobin (HbA1c), serum visfatin, glucose and lipid metabolism and the perinatal outcome in pregnant women with normal glucose tolerance (NGT). Methods A total of 135 NGT pregnant women diagnosed by oral glucose tolerance test (OGTT) entered this study. Patients were divided into two groups, high HbA1c group (HbA1c≥5.5%, n=66) and normal HbA1c group (HbA1c＜5.5%, n=69). The clinical data were collected in two groups. HbA1c levels were measured by HPLC, and the serum visfatin levels were measured by ELISA method. The values of body mass index (BMI), pregnant weight gain, visfatin, glucose and lipid met-abolic levels were analyzed between two groups. The relationship between levels of HbA1c, visfatin, glucose and lipid metab-olism and perinatal outcome were compared between two groups.Results The values of mean pregnancy weight gain, visfa-tin, total cholesterol (TC), triacylglycerol (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were higher in high HbA1c group than those of normal HbA1c group. In NGT women with high HbA1c level,there were higher average birth weight, lower blood glucose level in newborn babies and higher rates of cesarean section. The incidences of polyhydram-nios, meconium-stained fluid, macrosomia and neonatal hypoglycemia were also higher in NGT women with high HbA 1c than those of normal HbA1c group. There was a positive relationship between HbA1c level, pregnant weight gain and visfatin and birth weight of newborn babies in 135 NGT pregnant women. Conclusion The excessive weight gain during pregnancy can induce the up-regulation of the visfatin level, resulting in the increased blood glucose level. The optimal timing and mode of delivery could prevent the occurrence of adverse pregnancy outcomes.

Objective To explore clinical characteristics and the perinatal effects of multiple systems in pre-pregnancy obesity patients with early-onset preeclampsia. Methods A total of 111 cases with early-onset preeclampsia in our Inpatient Obstetric Department were reviewed in this study. According to pre-pregnancy body mass index (BMI), patients were divided into normal before pregnancy group (BMI<28 kg/m2, n=56) and obese before pregnancy group (BMI≥28 kg/m2, n=55) . The body weight, BMI, weight gain during pregnancy, risk factors, clinical features, and clinical features of neonatal index were compared between two groups. The correlation between maternal and neonatal indexes and glucose and lipid indexes were compared. Results Obese before pregnancy was more prone to blood concentration and disorders of lipid metabolism. The serum levels of lipid, glycosylated hemoglobin (HbA1c), hematocrit, platelet and fibrinogen were significantly higher in obese before pregnancy group than than those of normal group. The induced neonatal acidosis and other organ damage, newborn Apgar score, pH, glucose were significantly lower in obese before pregnancy group than those of normal group. The residual alkali (BE), lactic acid (LAC), creatine kinase (CK) and creatine kinase (CKMB) were higher in obese before pregnancy group than those of normal before pregnancy group. Correlation analysis showed that maternal low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), three acyl glycerol (TG) and HbA 1c were negatively correlated with neonatal Apgar score and pH, and which were positively correlated with neonatal LAC and CKMB. Both differences were significant (P<0.05 or P<0.01). Conclusion The dyslipidaemia in early onset preeclampsia in obesity patients before pregnancy is closely related with maternal and perinatal outcomes.

To investigate the effect of serum uric acid concentration on prenatal outcome in pregnancy induced hypertension (PIH) patients. Methods:Serum uric acid (UA),creatinine (Cr) and urea nitrogen (BUN) were measured in 248PIH patients. The prenatal prognosis was analyzed. Results: Serum UA concentration was closely related to the degree of PIH. The level of UA in severe PIH patients was significantly higher than in mild and moderate PIH patients ( P ＜ 0.01, P＜ 0.01 ). When UA levels rose,the incidences of intrauterine growth retardation,dead fetus,intrauterine distress and newborn mortality increased significantly. The higher the UA level was, the worse the prenatal prognosis was. Conclusion: In PIH patients,the serum UA level is closely related to the prenatal outcome. It can be used to assess the prenatal prognosis and as an index to terminate gestation appropriately

Background and objective Endometrial carcinoma is the most common gynecologic malignancy in the world. Although the insulin-resistant state or hyperinsulinemia was recently suggested as a potent risk factor for endometrial carcinogenesis and progression, there is only limited supporting evidence and the mechanism is unclear. In this study, we explored the roles of phosphatidylinositol 3-k/nase (PI3K)/Akt signaling pathway in the response of a human endometrial cancer cell line, Ishikawa3-H-12 cells, to insulin.Methods The Ishikawa 3-H-12 cells were serum-starved and then stimulated by insulin at various concentrations and for different time periods. To identify the insnlin-mediated signal pathway in the cells, LY294002, a selective inhibitor of PI3K, was used. The proliferation and the apoptotic rates were determined with methyl thiazolyl tetrazolium (MTT) and flow cytometric assays, respectively.Results The insulin receptor positive Ishikawa 3-H-12 cells had enhanced proliferation upon insulin stimulation in a rinse-and time-dependent manner. The growth promoting effect of insulin was blocked when the cells were pre-incubated with LY294002 for 60 rains.Insulin was able to protect the cells from serum-starvation-induced apoptosis in a concentration-dependent manner, while the anti-apoptotic effects of insulin was reversed by adding LY294002. Treatment with insulin at 1 μM for 15 rain resulted in an increased level of activated Akt The insulin-induced Akt activation was inhibited by LY294002 in a dose-dependent manner.Conclusion Insulin activates PI3K/Akt signaling pathway and is a mitogenic and anti-apoptotic agent for Ishikewa 3-H-12 endometrial cancer cells.

Objective To investigate the mRNA,protein expression and tyrosine phosphorylation of insulin receptor substrate.1(IRS-1)in endometrial carcinoma.Methods Sixty-three endometrial carcinoma(EC)patients,21 endometrial atypical hyperplasia(AHE)patients and 22 normal control(NE) entered this smdy.Their clinical information were colleeted Fasting serum C-peptide concentration was measured.Expression of IRS-1 in endometrium was examined by RT-PCR and western blol Immunoprecipitation was used to measure the tyrosine phosphorylation of IRS-1.Results C-peptide 0.007].There were no significant differences in IRS-l mRNA and protein expression among the three grouDs.Tyrosine phosphorylation of IRS-1 in EC group[(62±36)%]was higher than that in AHE and NE groups[(53 4-34)%and(35 4-33)%;P=0.048,0.002].IRS-1 activation in AHE group was also higher than nornlal control(P=0.045).IRs-1 activation in endometrioid carcinoma[(69 4-33)%]was higher than that in other histological types[(34±31)%;t=2.300,P=0.025].IRs-l tyrosine phosphorylation was significantly higher in patients with advanced stage,high grade,deep myometrial invasion and pelvic lymph node metastasis.IRS-l activation in endometrium was positively correlated with fasting sertlm C-peptide concentration(r=0.491,P=0.001).Conclusions There is excessive activation of IRS-1 in endometrial carcinoma and atypical hyperplasia.Activation of IRS-I in endometrial carcinoma is related with poor clinical-pathologic fleatures and may be a prognostic predictor for this tumor.Over-activationof IRS-1 may be an intermediate event linking the hyperinsulinemia and endometrial carcinoma.

Objective To investigate the effects of soluble endoglin(sEng)on nitric oxide (NO)production and endothelial nitric oxide synthase(eNOS)phosphorylation in cultured human umbilical vein endothelial cells.Methods Human umbilical vein endothelial cells within 3 passages seeded in culture plates of 96 wells,were stimulated by total culture medium(control group)or sEng (1,10 and 100 μg/L)respectively.Cells and medium were collected after cells were cultured for 6,12 and 24 hours respectively.The concentration of the metabolites of NO in each group was measured by nitrate reductase method.The expression of eNOS and eNOS-Ser(p)1177 were detected by Western blot.The expression of eNOS mRNA in each group was detected by real-time fluorescence reverse transcription-polymerase chain reaction.Analysis of variance,LSD method and pearson correlation were used to compare the difference between groups.Results(1)The concentration of the metabolites of NO in 1,10 and 100μg/L sEng groups was(59.25±1.63),(41.08±2.71)and (30.38±1.63)μmol/L respectively after cultured for 6 hours;(54.98±3.34),(35.00±8.60)and (19.82±3.75)μmol/L for 12 hours; and(46.14±4.93),(30.24±2.08)and(12.78±5.01)μmol/L for 24 hours.There was no significant changes in control group with time going by(F=2.30,P=0.14).The concentration of the metabolites of NO was significantly lower in sEng group,and which had negative correlation with culture time(r=-0.98,P＜0.05)and dose(r=-0.88,P＜0.05).(2)The expression of eNOS in 1,10,100 μg/L sEng groups was 0.71 ± 0.00,0.47 ± 0.00 and 0.32±0.00 after cultured for 6 hours; 0.58±0.00,0.42±0.00 and 0.25±0.00 for 12 hours; and 0.49±0.00,0.33±0.00 and 0.18±0.00 for 24 hours.While the expression of eNOS and eNOS-Ser (p)1177/eNOS had no significant changes in control group with time going by(F=3.59 and 0.37,P=0.09 and 0.80).The expression of eNOS protein and eNOS-Ser(p)1177 decreased significantly in sEng groups,which had negative correlation with culture time(r=0.98 and-0.96,P＜0.05)and dose(r=-0.76 and-0.79,P＜0.05).(3)The expression of eNOS mRNA decreased significantly in sEng groups.Which also had negative correlation with culture time(r=-0.51,P＜0.05)and dose(r=-0.82,P＜0.05).Conclusions sEng might inhibit eNOS activity by blocking 1177 Ser phosphorylation to decrease NO production.

Objective To investigate the expression of transforming growth factor-β1 (TGF-β1),endoglin (Eng) and their mRNA in placenta and superficial myometrium of patients with gestational hypertension or preeclampsia and to explore the role of Eng and TGF-β1 in the pathogenesis of gestational hypertension or preeclampsia.Methods One hundred and ten pregnant women were selected in the Second Affiliated Hospital of Tianjin Medical University from April 2009 to April 2010 who underwent cesarean sections and were divided into four groups:gestational hypertension group (n=30),mild preeclampsia group (n=30),severe preeclampsia group (n=30) and control group (normal pregnant women without labor and perinatal complications,n=20).The tissues of placenta and superficial myometrium were collected during cesarean section.Protein levels of Eng and TGF-β1 were detected by Western Blot.Real-time fluorescence reverse transcription polymerase chain reaction was used to detect the Eng and TGF-β1 mRNA expression.One-way ANOVA was used to compare among groups,Student-Newman-Keuls test was used to compare the differences between groups; relation between groups was analyzed by Pearson relation and linear regression.Results In control group,gestational hypertension group,mild and severe preeclampsia group,the Eng mRNA level was 1.00,1.27±0.58,1.54±0.41 and 1.83±0.35,and the TGF-β1 mRNA level was 1.00,1.64 ± 0.33,1.92± 0.38 and 2.23 ± 0.53 in placenta respectively; those figures changed to 1.00,1.32±0.46,1.59±0.37 and 1.93±0.52,and 1.00,1.71 ± 0.45,1.91 ± 0.51 and 2.37 ± 0.46 in superficial myometrium respectively.The Eng and TGF-β1 mRNA levels of control group were lower than those of the other three groups (P＜0.05).The higher the mRNA level,the more severe the disease (P＜ 0.05).In control group,gestational hypertension group,mild and severe preeclampsia group,the Eng protein expression was 0.11±0.07,0.15± 0.05,0.18 ± 0.06 and 0.43 ± 0.04,and the TGF-β1 protein expression was 0.11 ±0.02,0.26 ± 0.05,0.27± 0.03 and 0.88 ± 0.09 in placenta respectively; those figures changed to 0.14±0.06,0.16±0.04,0.20±0.08 and 0.46±0.05,and 0.15±0.03,0.29±0.06,0.31±0.04 and 0.91 ±0.08 in superficial myometrium respectively.The Eng and TGF-β1 protein levels of control group were lower than those of the other three groups (P＜0.05).The higher the protein level,the more severe the disease (P＜0.05).In the gestational hypertension group,mild and severe preeclampsia group,there were positive correlations between Eng and TGF-β1 protein levels in placenta (r=0.57,0.61 and 0.60 respectively,P＜0.05) and superficial myometrium (r=0.59,0.62 and 0.61 respectively,P ＜ 0.05).Conclusions Eng and TGF-β1 might play a role in pathogenesis of gestational hypertension and preeclampsia.

Objective:To investigate the relationship between plasma placental growth factor(PIGF) levels and perinatal outcomes in patients with early onset preeclampsia(EOPE).Methods:125 patients with EOPE undergoing cesarean section were enrolled in this study.Enzyme-linked immunosorbent assay(ELISA) was used to detect the level of maternal plasma PIGF.According to the plasma PIGF level,≤ 12 pg/ml was divided into PlGF≤12 pg/ml group(n =64) and PIGF ＞12 pg/ml was in PIGF ＞12 pg/ml group(n =61).The blood gas analysis and the level of lactic acid(LAC) were measured within 1 hour after fetal birth.The routine and biochemical indexes of two groups and their relation with perinatal outcomes were compared.Results:①In PIGF ≤ 12 pg/ml EOPE group,the Hb,HCT,24h urine protein level,BUN and Cr levels were higher than those in PIGF ＞ 12 pg/ml group (P ＜ 0.05).While the ALB level was lower than that of PIG F ＞ 12 pg/ml group (P ＜ 0.05).②The gestational age of PIGF≤12 pg/ml group was less than that of PIGF ＞ 12 pg/ml group,but the proportion of oligohydramnios,meconium stained amniotic fluid and less than gestational age infants(SGA) were all higher than those of PIGF ＞ 12 pg/ml group(P＜0.05).③In the PIGF≤12 pg/ml group,neonatal birth weight(BW),1 minute Apgar score,pH,serum Ca,BE were all lower than those in PIGF ＞12 pg/ml group.But the level of LAC and the NICU hospital stay were all higher than those in PIGF ＞ 12 pg/ml group (P ＜ 0.05).Conclusions:In EOPE patients,plasma PIGF level has certain clinical value in predicting perinatal outcome.If PIGF is ≤ 12 pg/ml,the maternal renal dysfunction may be more obviously,and there is higher incidence of oligohydramnios,meconium stained fluid,SGA and neonatal asphyxia,and the newborn is more susceptible to metabolic imbalance and acid-base disorders.Mother and child care should be strengthened.

Objective To analyze the influences of maternal high-fat diet on male rat offspring's blood lipid level and hepatic lipid deposition as well as on the expression of two key factors,sterol regulatory element binding protein-1 (SREBP-1) and SREBP cleavage acting protein (SCAP),involved in hepatic cholesterol regulatory cascade during childhood and adulthood.Methods Pregnant Wistar rats were randomly divided into two groups:high fat diet (HF) group and normal intake control (NC) group (both n=20).Rats in the HF group were fed with high-fat diet till delivery before changing to a normal-fat diet,while the NC group was given the normal-fat diet all through the study.Male offspring born appropriate for gestational age (AGA) in different feeding groups were randomly selected as experimental subjects.Physical development,serum lipid levels and hepatic lipid deposition at the age of 7 and 24 weeks were compared between offspring of the two groups.Expression of SCAP and SREBP-1 at protein level was detected with immunohistochemistry.T test or Chi-square test was used for statistical analysis.Results The average birth weight of HF group was higher than that of NC group [(6.95± 0.25) vs (6.79 ±0.78) g,t=2.088,P=0.038].Large for gestational age (LGA),AGA and small for gestational age (SGA) offspring accounted for 18.6％ (21/113),77.9％ (88/113)and 3.5％ (4/113) in HF group and 7.6％ (10/132),87.9％ (116/132) and 4.5％ (6/132) in NC group (x2=13.500,P=0.001).At the age of 7 weeks,the offspring's body weight in HF group was higher than that in NC group [(68.78±7.55) vs (66.61 ±3.92) g,t=2.303,P=0.023].At the age of 24 weeks,the body weight,body length and abdominal circumference of adult offspring in HF group were significantly higher than those in NC group [(251.74±24.04) vs (216.24±33.42) g,(22.60±0.79) vs (21.59± 1.34) cm,(17.93±0.59) vs (16.83±0.88) cm;t=2.220,2.379,2.927,all P＜0.05].At the age of 7 weeks,offspring's serum total cholesterol (TC) level in HF group was higher than that in NC group [(1.94±0.62) vs (1.23 +0.77) mmol/L,t=2.379,P＜0.05].At the age of 24 weeks,adult offspring's liver index,serum TC,triglyceride (TG),low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein-cholesterol (VLDL-C) levels were all higher in HF group than in NC group,while the high density lipoprotein-cholesterol (HDL-C) level was lower in HF group [(2.75±0.31)％ vs (2.46±0.39)％,(1.98±0.14) vs (1.45±0.27) mmol/L,(2.96±0.21) vs (2.71 ±0.29) mmol/L,(0.97±0.32) vs (0.71 ±0.21) mmol/L,(0.81 ±0.13) vs (0.52±0.17) mmol/L,(1.74±0.20) vs (1.59±0.29) mmol/L;t=2.264,2.333,2.359,2.088,5.336,1.994,all P＜0.05].Comparative analysis of nonalcoholic fatty liver disease activity scores (NAS) between the two groups showed that the liver lobular inflammation in HF group's offspring was more severe at both 7 and 24 weeks of age (2.29±0.49 vs 1.92±0.45,2.83±0.47 vs 2.22±0.55;t=2.157,3.251,all P＜0.05).At the age of 24 weeks,adult offspring in HF group also showed higher liver steatosis scores (2.81 ± 0.35 vs 2.25 ± 0.30,t=4.609,P＜0.05).Immunohistochemical detection showed that there was no significant difference in SCAP protein expressions in liver tissues of 7-week-old offspring between the two groups (P＞0.05),but higher expression of SREBP-1 protein was observed in HF group than in NC group [(34.16±5.08)％ vs (18.09±3.99)％,t=9.697,P＜0.05].At the age of 24 weeks,the expression levels of both SCAP and SREBP-1 proteins in liver tissues were higher in HF group than in NC group [(31.22±6.01)％ vs (17.98+7.89)％,(61.33± 16.25)％ vs (29.76± 11.21)％;t=2.303,2.274,both P＜0.05].Conclusions High-fat intake during pregnancy can increase offspring's birth weight and the risk for LGA offspring.Maternal high-fat diet even up-regulates the expression of SCAP and SREBP-1 in male offspring born AGA in childhood and this impact become more obvious when reaching adulthood,resulting in excessive increase of body weight,body length and abdominal circumference and elevated serum lipid level and liver lipid deposition.