Role of omentin-1 and vaspin in the early diagnosis of gestational diabetes mellitus

Objective To explore the value of serum omentin-1 and vaspin levels in early diagnosis of gestational diabetes mellitus (GDM). Methods A total of 101 GDM patients who underwent routine prenatal examination in the Affiliated Hospital of Hebei University from June 2016 to December 2017 were selected, including 46 women who were obese before pregnancy (a pre-gestational obese GDM group) and 55 women who were normal before pregnancy (a pre-gestational normal GDM group). Meanwhile, 161 pregnant women who did not have gestational diabetes during the same period were selected and set as a normal glucose tolerance group. The levels of serum omentin-1, chemerin, leptin, APN and vaspin in the first trimester (13 weeks of gestation) were detected. After the oral glucose tolerance test (OGTT), blood glucose, insulin, glycosylated hemoglobin (HbA1c) and blood lipid were measured, and the homeostasis model was calculated to evaluate homeostasis model assessment of insulin resistance (HOMA-IR). Results The pre-gestational normal GDM group presented remarkable decreases in body weight index (BMI)1, BMI2, and BMI3, compared with the pre-pregnancy obese GDM group (P<0.05). The normal glucose tolerance group showed significantly lower BMI3 during pregnancy than the pre-gestational normal GDM group and the pre-gestational obese GDM group (P<0.05). The pre-gestational normal GDM group presented remarkable decreases in fasting blood glucose, 2 h postprandial blood glucose and HOMA-IR during pregnancy, compared with the pre-pregnancy obese GDM group (P<0.05). The normal glucose tolerance group showed significantly lower fasting blood glucose, 2 h postprandial blood glucose and HOMA-IR during pregnancy than the pre-gestational normal GDM group and the pre-gestational obese GDM group (P<0.05). The pre-gestational normal GDM group presented remarkable decreases in vaspin and chemerin expression and increases in omentin-1, compared with the pre-pregnancy obese GDM group (P<0.05). The normal glucose tolerance group showed significantly lower vaspin and chemerin but higher APN and omentin-1 than both the pre-gestational normal and obsess GDM groups (P<0.05). The normal glucose tolerance group showed significantly higher total cholesterol than both the pre-gestational normal and obsess GDM groups (P<0.05). Furthermore, HOMA-IR and early vaspin and omentin-1 are the independent predictors of gestational diabetes. Conclusions Patients with gestational diabetes show glucose and lipid metabolism disorders, insulin resistance with high levels of vaspin, low levels of o mentin-1. Obese patients often have unbalanced glucose and lipid metabolism, more severe insulin resistance, and high levels of vaspin and omentin- in the first trimester may predict the occurrence of gestational diabetes.