自身抗体阳性妊娠期糖尿病与HLA-DRB1基因型相关分析  

The prevalence of HLA-DRB1 gene type in women with autoimmune gestational diabetes

作　　者：李芳[1] 李焱[1] 汤雪薇[1] 宋淑本[1] 卢锦娥[1] 卢钺成[1] 袁思敏[1] 廖灿[1] 

机构地区：[1]广东省广州市妇婴医院,510180

出　　处：《中国妇幼保健》2007年第33期4754-4757,共4页Maternal and Child Health Care of China

摘　　要：目的:评估胰岛自身抗体阳性的妊娠期糖尿病(GDM)孕妇人类白细胞抗原DRB1位点(HLA-DRB1)基因频率分布及HLA-DRB1基因与其妊娠结局的相关性。方法:对2004年在我院产检无糖尿病史的广东省籍汉族GDM孕妇116例,测定谷氨酸脱羧酶抗体(GADA),胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA),以及用序列特异性引物杂交技术(PCR-SSOPH)进行HLA-DRB1基因分型。抗体阳性的42例纳入研究组,抗体阴性的74例为对照组。比较两组GDM孕妇的妊娠结局和产后6周血糖情况。结果:研究组的孕妇比对照组孕前BMI较低,妊娠失败可能性较高。1型糖尿病相关的HLA-DRB1基因频率分布在两GDM组间差异无显著性,但两组HLA-DRB1*04-频率均高于正常人群(P<0.01)。结论:自身抗体阳性的GDM孕妇可能有1型糖尿病遗传背景和免疫反应,应严密监护,加强随访。Objective： To estimate the prevalence of HLA - DRB1 gene type in women with autoimmune gestational diabetes whose autoantibody against the beta cells of pancreas islet was positive and to assess the association between HLA - DRB1 gene type, and their gesta- tion outcomes. Methods： Women with gestational diabetes who lived in Guangdong province without diabetes history and came for anatenatal care in 2004 were randomized enrolled. ICA, GADA, and IAA were detected by ELISA. HLA - DRB1 was tested by polymerase chain reaction sequence specific oligonucleotide probes hybridization （PCR - SSOPH）. The general clinical characteristics, gestation outcomes and puerperal serum glucose concentrations were investigated. Results： There were 42 cases which included 36 GADA positive cases, 12 IAA positive cases and 5 ICA positive cases in the autoimmune GDM group, compared with 74 cases in the nonautoimmune GDM group whose autoantibody was negative. Significantly lower BMIs and more frequent failures of pregnancies were found in the autoimmune GDM group. Although HLA - DRB 1 ＊ 04 seemed to be more frequent （0. 214 and 0. 149, respectiveIy） and HLA - DRB1 ＊ 09 seemed to Iess common in the autoimmune GDM group （0. 119 and 0. 176, respectively）, there was no significant difference compared with the nonautoimmune GDM group. The frequence of HLA -DRB1 ＊ 04 in both GDMgroup seemed to be more frequent than population. Conclusion： The autoimmune GDM patients might have the same genetic background and autoimmune reaction as the type 1 diabetes, who should be monitored closely and follow - up in a long - term.

关 键 词：妊娠期糖尿病 自身抗体 HLA—DR抗原 基因型 

分 类 号：R714.25[医药卫生—妇产科学]