Objective To investigate the role of endoplasmic reticulum stress markers in peripheral blood mononuclear cells(PBMCs)of patients with gestational diabetes mellitus(GDM)in placental dysfunction.Methods Select 100 singleton patients with 30-32 weeks of pregnancy who received outpatient or inpatient treatment at our hospital from January 2022 to June 2023.Among them,50 outpatient patients were the control group with normal blood glucose regulation during pregnancy.50 hospital-ized patients with GDM during mid pregnancy(24-28 weeks of pregnancy)were selected as the study group to achieve blood glucose control through diet or insulin therapy.Expression of endoplasmic reticulum stress(ERs)pathway related biomarkers,including activating transcription factor 4(ATF4)and enhancer binding protein homologous protein(CHOP),analyzed by PCR Results Compared with the control group,fasting blood glucose,blood glucose at 2 hours after 75 g glucose loading,sFlt-1 and sFlt-1/PLGF ratio in GDM group increased significantly,and PLGF level decreased significantly.Compared with the control group,the expression of ATF4 and CHOP genes in monocytes in GDM group increased significantly.For the whole cohort,the expression of ATF4 and CHOP genes in peripheral blood monocytes increased with the increase of sFlt-1/PLGF ratio(F=60.79,25.58,all P<0.001).Correlation analysis showed that the expression of ATF4 and CHOP genes was positively correlated with the ratio of sFlt-1/PLGF.According to ROC analysis,it was found that the AUC of ATF4 in predicting GDM was 0.801,the sensitivity was 92.1%,and the specificity was 76.0%.The AUC of CHOP for predicting GDM was 0.738,and it had a sensitivity of 75%and a specificity of 80%.Conclusions GDM has adverse effects on placental function.ATF4 and CHOP may be poten-tial markers for early detection of placental endothelial dysfunction in the fetus.
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