妊娠期糖尿病患者脂肪细胞因子与炎症的相关性分析  

Correlation analysis of serum adipocytokines and inflammation in women with gestational diabetes mellitus

作　　者：陈利春[1] 陈冠军[2] 叶俊良[1] 黄大雁[1] 刘治春[1] 孙玉秀[1] 汪凌云[2] 陈莉[2] 鲁云霞[2] 

机构地区：[1]安徽医科大学妇幼保健临床学院,合肥230001 [2]安徽医科大学生物化学教研室,合肥230032

出　　处：《安徽医科大学学报》2012年第7期842-845,共4页Acta Universitatis Medicinalis Anhui

基　　金：合肥市科技局基金项目(立项文见<合科[2011]25号文件>)

摘　　要：目的探讨妊娠糖尿病(GDM)患者脂肪细胞因子瘦素、视黄醇结合蛋白4(RBP4)、脂联素与炎症细胞因子白介素6(IL-6)、肿瘤坏死因子α(TNF-α)的关系。方法选择GDM患者60例,正常糖耐量(NGT)孕妇44例,根据体重和身高计算晚孕期体重指数(BMI);检测空腹血糖(FBG)水平,计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI);酶法检测血清甘油三酯(TG)、总胆固醇(TC);比色法测定游离脂肪酸(FFA)水平;ELISA法检测所有孕妇血清中脂联素和RBP4水平;放射免疫法检测空腹胰岛素(FIns)、瘦素、IL-6、TNF-α水平。将两组孕妇的各指标之间进行Pearson相关分析。结果与NGT组比较,GDM组的FPG、TG、TC、FFA、瘦素、IL-6、TNF-α、RBP4水平均明显升高,脂联素水平明显下降,存在显著的炎性激活及胰岛素抵抗;HO-MA-IR、RBP4、瘦素与IL-6、TNF-α呈正相关;ISI、脂联素与IL-6、TNF-α呈负相关。结论 GDM患者由于过度分泌的脂肪细胞因子和炎性因子导致显著的炎性激活,可能是GDM中胰岛素抵抗发生发展的机制之一。Objective To investigate the correlation between inflammatory factors IL-6, TNF-α and related adipocyte factors [ adiponectin, leptin and retinol-binding protein 4 （RBP4） ] in gestational diabetes mellitus （ GDM ） patients. Methods GDM patients（ GDM group, n = 60） and pregnancies with normal glucose tolerance（ NGT group, n = 44） were enrolled, late gestational body weight was recorded, and BMI was calculated. FBG level was assayed with glucose oxidase method. ISI and HOMA-IR were calculated, serum TG, TC, ALT, AST and FFA levels were measured with enzyme methods. The concentrations of serum adiponectin and RBP4 were determined by ELISA. Serum Fins, leptin, IL-6 and TNF-α level were assayed by radioimmunoassay. The correlations between inflammatory factors and related adipocyte factors were analyzed with Pearson correlation assay. Results Compared with those in NGT group, the FPG, TG, TC, FFA, leptin, IL-6 and TNF-α were significantly increased, serum adi- ponectin level was significantly decreased in GDM group, which indicated significant inflammatory activation and insulin resistance; HOMA-IR, RBP4 and leptin were positively related with IL-6 and TNF-α, ISI and adiponectin were negatively related with IL-6 and TNF-α. Conclusion High expression of adipocytokines in GDM patients are positively correlated with inflammatory cytokines. It may be one of mechanism for insulin resistance in GDM patients.

关 键 词：妊娠糖尿病 脂肪细胞因子 胰岛素抵抗 炎症 

分 类 号：R714.25[医药卫生—妇产科学]