Abstract:Objective To investigate the expressions of Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) and NF-κB in placental tissues of women with gestational diabetes mellitus(GDM) and the relationship between TLR4 and insulin resistance(IR). Methods Thirty- two patients with GDM admitted to Rugao People′s Hospital from December 2017 to December 2018 were selected as GDM group, and 30 normal pregnant women were served as control group at the same time.The levels of IR related indices in the peripheral blood were measured before delivery, and the mRNA and protein expressions of TLR4/MyD88/NF-κB in placental tissue were determined by real-time quantitative PCR and immunohistochemistry in two groups.Spearman rank correlation analysis was used to determine the relationship between TLR4 expression level and IR in GDM women.Results The levels of fasting blood glucose(FBG), fasting insulin (FINS) and Homeostasis model assessment-insulin resistance (HOMA-IR) index in GDM group were significantly higher than those in control group (P<0.01), but HOMA-β levels were similar between two groups(P>0.05).The relative mRNA expressions and protein levels of TLR4/MyD88/NF-κB in maternal and fetal surfaces of the placenta in GDM group were significantly higher than those in control group (P<0.05).Spearman test showed that the expression level of TLR4 in maternal and fetal surfaces of placenta was positively correlated with HOMA-IR in GDM group(r=0.596, P<0.01; r=0.326, P<0.01).Conclusion The expression of TLR4/MyD88/NF-κB is increased in placenta of GDM women, and the protein expression level of TLR4 is directly related to the degree of IR.