OBJECTIVE -The aim of this study was to investigate the prevalence of gestational diabetes mellitus (GDM) and risk factors for the development of GDM in pregnant women in Tianjin, China, where the prevalence of GDM is still unknown.STUDY DESIGN AND METHODS -A total of 9,471 pregnant women living in the six urban districts of Tianjin, China, took part in the initial screening between December 1998 and December 1999. The screening test consisted of a 50-g 1-h glucose test. Women with a reading Ն7.8 mmol/l at the initial screening were invited to undergo a 75-g 2-h oral glucose tolerance test (OGTT). GDM was confirmed using the World Health Organization's diagnostic criteria.RESULTS -At the initial screening test, 888 women had a glucose reading of Ն7.8 mmol/l. A total of 701 (79%) women took a subsequent OGTT. Of these, 174 women were confirmed to have GDM (154 with impaired glucose tolerance [IGT] and 20 with diabetes). The prevalence of GDM was 2.31% (2.03% for IGT and 0.28% for diabetes), adjusting for serum glucose levels at the initial screening test. Independent predictors for GDM were maternal age, stature, prepregnancy BMI, weight gain in pregnancy before screening, diabetes in first-degree relatives, and habitual cigarette smoking during pregnancy. Women who smoked or had a short stature are more likely to develop GDM than their counterparts.CONCLUSIONS -The prevalence of GDM in pregnant women in the city of Tianjin, China, was 2.31%. Short stature and smoking in pregnancy were additional risk factors for GDM. Diabetes Care 25:847-851, 2002

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The American Diabetes Association (ADA) has recommended selective screening for gestational diabetes mellitus (GDM) (1). Pregnant women aged Ͻ25 years, who have normal body weight, no family history of diabetes, and are not members of an ethnic/racial group with a high prevalence of diabetes, are regarded as a low-risk group for GDM and need not be screened. The effect of selective screening guidelines has been investigated in Caucasian populations using a 100-g 3-h oral glucose tolerance test (OGTT) (2,3). We report here the effect of the selective screening protocol.A total of 9,471 pregnant women in Tianjin, China, took part in a universal screening program from December 1998 to December 1999. The screening test consisted of a 50-g 1-h glucose test and was carried out at 26-to 30-weeks' gestation. A total of 888 (9.4%) women had a glucose reading Ͼ7.8 mmol/l, of whom 701 undertook a further 75-g 2-h OGTT using the WHO diagnostic criteria for GDM (baseline: Ն7.0 mmol/l; 2-h: Ն7.8 mmol/l) (4). A total of 171 women were confirmed to have GDM (prevalence 1.8%).Age, prepregnancy BMI, and family history of diabetes were risk factors for GDM in this cohort. The prevalence of overweight (BMI Ն25 kg/m 2 ) was low (10%), and family history of diabetes was uncommon (8%). Furthermore, the onechild policy has resulted in a cohort of 98% (9,240/9,471) of nulliparas. Twenty-eight percent of women were Ͻ25 years of age.The application of the ADA selective screening guideline in this study would exclude 24% (2,248/9,469) of women from the screening test. An estimated 12% of women with confirmed GDM under the WHO criteria would otherwise have been denied the opportunity for early detection. These findings differ substantially from reports using the ADA recommendations: exclusion of 10% of women in the screening and oversight of 4% of GDM women (3).We adopted a similar, although slightly later, approach to the initial screening (26-to 30-vs. 24-to 28-weeks' gestation) (1). The WHO diagnostic criteria have been shown to give a higher estimation of GDM prevalence (5,6) in comparison with the ADA criteria. However, the prevalence of GDM in our study population was low. As our subjects are deemed a high-risk group (of Asian backgrounds) under the ADA selective screening guidelines, the lack of other risk factors is an important determinant of GDM prevalence. The greater proportion of Chinese women with GDM who would fail to be identified using selective screening, compared with the proportion shown in other studies, is unlikely to be explained by either the delay in screening or the use of the WHO criteria. The low frequency of risk factors for GDM in this cohort was associated with a low prevalence of GDM. However, young and lean women were not immune from the development of GDM. We conclude that if selective screening is to be considered in this population, different age and BMI cutoff points are required, and other risk factors for GDM (such as stature) may need to be considered for inclusion in any revised selective screening r...

nephrotic syndrome (nS) is one of the most common causes of chronic kidney disease in the pediatric population. Hyperlipidemia is one of the main features of nS. The present study investigated the role of cXc motif chemokine ligand 16 (cXcl16) and adaM metallopeptidase domain 10 (adaM10) in oxidized low-density lipoprotein (oxldl)-stimualted podocytes and the underlying mechanisms. cXcl16 and adaM10 expression levels in oxldl-treated podocytes were measured via reverse transcription-quantitative Pcr and western blotting. cell migration assays were conducted to assess the migration of oxldl-treated podocytes. cXcl16 or adaM10 overexpression and knockdown assays were conducted. The results indicated that oxldl stimulation increased adaM10 and cXcl16 expression levels, and enhanced podocyte migration compared with the control group. Moreover, cXcl16 and adaM10 overexpression significantly increased podocyte migration and the expression of actinin-α4 (acTn4) compared with the control groups. By contrast, cXcl16 and adaM10 knockdown significantly reduced podocyte migration and the expression of acTn4 compared with the control groups. The results suggested that oxldl promoted podocyte migration by regulating cXcl16 and adaM10 expression, as well as by modulating the actin cytoskeleton. Therefore, cXcl16 and adaM10 may serve as novel therapeutic targets for primary nephrotic syndrome in children.