Objective The rs10229583 polymorphism near paired box gene 4 ( PAX4) is associated with insulin resistance and type 2 diabetes. Mutations in the PAX4 gene may be associated with impaired differentiation/development of pancreatic islet beta cells during fetal development and, consequently, a compromised insulin response to high blood glucose. To ascertain whether this polymorphism plays a role in gestational diabetes mellitus (GDM), we investigated the genotypic and allele frequency differences between GDM and normal pregnancies. Methods A total of 310 GDM and 440 normal pregnancies were evaluated. Allele and genotype frequencies of rs10229583 were determined for all participants with Sanger sequencing and SNaPshot. Association of the allele and genotypes of the single nucleotide polymorphism with the disease was analyzed using Pearson’s χ 2 test and OR (odds ratio). Results The G allele was more frequent in patients with GDM compared with controls (OR = 1.47, 95% confidence interval (CI): 1.12–1.939). The GG genotype frequency of rs10229583 was significantly different between subjects with GDM and normal controls (OR = 1.411, 95% CI: 1.032–1.928). The OR of the GA + GG genotype was 3.182 (95% CI: 1.294–7.826) for patients with GDM compared with controls. Conclusion The present study suggests that rs10229583 is associated with GDM.

妊娠期糖尿病（GDM）是1种妊娠后首次发现或发病的糖尿病，不仅增加围产期孕妇和胎儿的风险，也增加这些孕妇远期发生2型糖尿病（T2DM）、代谢综合征及其子代肥胖的概率。目前，GDM的病因及发病机制尚未完全明确，但其与T2DM具有相似的临床特征，均存在胰岛素分泌缺陷或胰岛素抵抗，提示两者可能存在相同的遗传基础[1-2]。近年来的研究证实，褪黑素受体（MTNR）1B基因是T2DM的候选基因[3]，MTNR1B基因rs10830962位点单核苷酸多态性（SNP）与葡萄糖代谢和胰岛β细胞的功能密切相关，与T2DM的发病具有高度的相关性[4]。该基因位于染色体11q21~q22，编码高亲和力G蛋白偶联受体，与松果体分泌的激素--褪黑素（melatonin）结合而发挥生理作用。2012年，Kwak等[5]通过对韩国GDM人群的研究发现，MTNR1B基因rs10830962位点SNP与GDM的发病具有显著相关性。2013年，Li等[6]通过对中国汉族的GDM患者及正常孕妇的MTNR1B基因rs10830962位点进行研究，结果发现， rs10830962位点SNP与GDM发病无明显相关性。上述两项研究的结果不同，提示，GDM的发病在不同的人群中可能存在一定的遗传异质性。本研究采用Sanger测序技术及小测序法（SNaPshot）分型技术，探讨MTNR1B基因rs10830962位点SNP与GDM发病的关系。现将结果报道如下。

BACKGROUND:Both misoprostol and prostaglandin E2 (PGE2) gel are used for labor induction in women with premature rupture of membranes (PROM). OBJECTIVES:To evaluate studies comparing the effects of misoprostol and PGE2 gel in labor induction. SEARCH STRATEGY:Databases including Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant papers. SELECTION CRITERIA:Randomized controlled trials comparing the use of misoprostol and PGE2 gel for labor induction in women with PROM were included. DATA COLLECTION AND ANALYSIS:For meta-analyses, the Mantel-Haenszel method was used for dichotomous data, and the inverse variance method was used for continuous data. MAIN RESULTS:Four randomized controlled studies (n=615) were included. There were no significant differences between the two groups in the induction-to-delivery interval (mean difference -4.44 hours; 95% confidence interval [CI] -9.35 to 0.48), rate of cesarean delivery (odds ratio [OR] 0.90; 95% CI 0.44-1.85), and rate of neonatal intensive care unit admission (OR 0.89; 95% CI 0.57-1.38). Women receiving misoprostol had a significantly higher rate of tachysystole than did those receiving PGE2 gel (OR 4.84; 95% CI 2.46-9.54). CONCLUSIONS:Misoprostol is as efficacious and safe as PGE2 gel for labor induction in women with PROM.