الفهرس 
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Abstract
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The definition applies whether insulin or only diet modification is used for treatment and whether or not the condition persists after pregnancy. It does not exclude the possibility that unrecognized glucose intolerance may have antedated or begun concomitantly with the pregnancy. GDM of any severity increases the risk of fetal macrosomia. Neonatal hypoglycemia, jaundice, polycythemia, and hypocalcaemia may complicate GDM as well. GDM is associated with an increased frequency of maternal hypertensive disorders and the need for cesarean delivery. The latter complication may result from fetal growth disorders and/or alterations in obstetric management due to the knowledge that the mother has GDM.
Visfatin refer to an identical protein, as judged by its amino acid sequence, with multiple biological functions. this protein has also been reported to be a cytokine (PBEF) that promotes B cell maturation and inhibits neutrophil apoptosis as well it was recently re-identified as a “new visceral fat-derived hormone” It was reported that visfatin is enriched in the visceral fat of both humans and mice
This study was designed to evaluate the role of visfatin in women with GDM among pregnant women, who were selected from obstetric outpatient clinic and inpatient department of obstetric hospital, Ain Shams University Hospital..
The present study comprised 40 subjects who were classified into two groups:
• Group I : 20 healthy pregnant females their age ranged between 20-35 years old at 28 weeks of gestation (interquartile range 27-36)
• Group II : 20 patients with GDM at the same time of gestation and the same age
All the included patients were subjected to full history taking , thorough clinical examination (emphathizing on Blood Pressure, BMI) as well Serum sampling that was tested for fasting plasma glucose level, HbA1c, fasting serum insulin level, HOMA-IR and fasting Serum visfatin level patient
The results were statistically analyzed and we observed the following:
» As regard Fasting serum visfatin it was higher in women with GDM than healthy control group.
» Regarding correlation of visfatin with different metabolic parameters there was a positive significant statistical correlation between visfatin and fasting plasma glucose level (r =0.46) with p <0.05, highly significant correlation with insulin(r =0.97), HOMA-IR(r =0, 94) as p value in all these parameters <0.01
» The probability (p) value was used for detection of correlation between two quantitative variables in one group and the significance of the test was determined to be Significant (S) if p value <0.05, non significant (NS) if p value >0.05, highly significant (HS) if p value < 0.01.
» The visfatin cutoff value was 50.85 which could differentiate normal pregnancy from cases with gestational diabetes, visfatin found to be highly sensitive and specific for detection of GDM.