Analysis of the relationship between PAPPA level,HbA1c with insulin resistance and pregnancy outcome in patients with gestational diabetes mellitus
Objective To analyze the relationship between pregnancy-associated plasma protein A(PAPPA)level,glycosylated hemoglobin(HbA1c)with insulin resistance and pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods A total of 95 GDM patients received in our hospital from September 2021 to June 2022 were included in observation group,and 95 pregnant women who came to our hospital for prenatal examination during the same period were included in control group.The general data and adverse pregnancy outcomes of the two groups were compared;the levels of PAPPA and HbA1c in patients with different insulin resistance grades and different pregnancy outcomes were compared.Results The body mass index(BMI),fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG),HbA1c,fasting insulin(FINS)levels and homeostasis model assessment insulin resistance index(HOMA-IR)in the observation group were higher than those in the control group,and the PAPPA level was lower than that in the control group(P<0.05).The total incidence of adverse pregnancy outcomes in the observation group was significantly higher than that in the control group(P<0.05).The PAPPA level of patients with insulin resistance grade Ⅰ was higher than that of grade Ⅱ and Ⅲ,and HbA1c was lower than that of grade Ⅱ and Ⅲ;the PAPPA level of patients with grade Ⅱ was higher than that of grade Ⅲ,HbA1c was lower than that of gradeⅢ(P<0.05).The PAPPA level in patients with adverse pregnancy outcomes was lower than that in patients with normal pregnancy outcomes,and HbA1c was higher than that in patients with normal pregnancy outcomes(P<0.05).Conclusion The PAPPA level and HbA1c in GDM patients are associated with insulin resistance and pregnancy outcomes.Low PAPPA level and high HbA1c can increase the risk of high insulin resistance and adverse pregnancy outcomes.
gestational diabetes mellituspregnancy-associated plasma protein Aglycosylated hemoglobininsulin resistancepregnancy outcome